Researchers Bringing Nose Cells to Knees for Joint Repair

Swiss researchers have reported positive early returns from a treatment that involves growing knee cartilage from extracted nasal cartilage. Whether patients will be doing yoga anytime soon remains to be seen.

Many people try to touch their knees to their noses in stretches or popular yoga poses. Many others can’t imagine doing such a thing, due to painful rheumatic conditions and sports injuries that result in damage to the articular cartilage in their knees.

A new experimental treatment for those people brings cartilage from their noses into their knees, in an effort to reliably regrow the vital cushioning layer in such all-important joints. Whether it’ll have anyone testing their yoga prowess again is unseen, and beside the point: results of a new study from Switzerland published this week in The Lancet showed that the treatment is plausible, and that at a short distance, it seemingly works.

Ten adult patients who had suffered major, cartilage-compromising knee injuries were included in the study. Each had a small cache of cartilage cells extracted from their own septum in a minimally invasive procedure. The cells were then treated with growth factor for two weeks, then seeded onto collagen membranes for another two. The result were 30x40x2mm cartilage grafts, which could be cut down to size and used to surgically replace the existing damaged cartilage, which was removed.

At 24 months, no procedure-related adverse events were reported, and 9 of the 10 patients testified to improved function and decreased pain in the treated joint. “Radiological assessments indicated variable degrees of defect filling and development of repair tissue approaching the composition of native cartilage,” write the authors. The study is ongoing, looking to monitor the implanted grafts over a long period of time.

In an accompanying commentary also published in The Lancet, Dr. Nicole Rotter and Dr. Rolf Brenner of Germany mull over the implications of cell-based therapies. They argue that no existing cartilage regeneration or replacement treatment can be considered a “gold standard”, but offer cautious optimism about these new cell treatments, particular how, in this case, the cells are harvested from elsewhere in the body rather than the damaged joint itself.

Such optimism abuts the original study’s cautious realism. It acknowledges that this isn’t yet close to being a practical, clinically applicable process, and at 24 months of observation little can be said for its long-term efficacy.

None of the 10 patients in the study are older than 55, and as lead researcher Ivan Martin of Switzerland says in a press release: “Moreover, in order to extend the potential use of this technique to older people or those with degenerative cartilage pathologies like osteoarthritis, a lot more fundamental and pre-clinical research work needs to be done."

Speaking to CNN, Dr. David Jevsevar, chair of the American Academy of Orthopedic Surgeon's Council on Research and Quality, mentioned that similar treatments involving test tube grown knee cartilage had been performed, the true test is simply time. Initial positive signs aren’t necessarily long term results.

So, perhaps it’ll be a while before anyone is bending knees repaired with nose cartilage to do yoga. In the meantime, the study is expanding to soon include 25 patients.

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