Study Underway to Determine the Effectiveness Of Cartilage Cell Transplants in the Knee
May 07, 1999
The University of Rochester Medical Center's Strong Memorial Hospital is one of the sites of a multi-center study to determine the effectiveness of cartilage cell transplants in the knee, compared to traditional surgical procedures.
For the knee to function normally, the articular cartilage (a thin layer of tough tissue, which covers the bone, ends where they meet at the joint), must be intact. However, injuries and trauma to the articular cartilage often fail to heal properly or fail to heal at all, resulting in great discomfort and/or pain for many individuals. Left untreated, injured articular cartilage can degenerate, resulting in osteoarthritis over time.
The traditional methods of treating knee cartilage injuries, abrasion arthroplasty and microfracture, are surgical procedures which scrape and cut away the injured cartilage and stimulate the underlying bone. These procedures promote the growth of a thick scar tissue -- fibrocartilage -- and cartilage cells beneath the injured cartilage, which then serve as protection for the bone ends. Since fibrocartilage is not as tough as articular cartilage, degeneration over time may occur.
The study at the University of Rochester Medical Center and at other sites across North America, treats injured knee cartilage through a completely different mechanism - by implantation of an individual's own cartilage cells. Autologous cultured chrondocyte implantation or cartilage cell transplantation works this way: a small section of an individual's uninjured cartilage is extracted and sent to a laboratory, where the cartilage cells are grown to abundance. The cells are then surgically implanted into the area of the injured cartilage and covered with a patch. Over time, these cartilage cells have the potential of producing cartilage quite similar to articular cartilage. There is a good possibility that this cartilage is stronger than fibrocartilage and has less chance of degenerating over time.
"Developed and performed for several years in Sweden, the results of autologous cultured chondrocyte implantation are quite encouraging, and the procedure offers yet another alternative to those individuals suffering from chronic knee pain due to injured cartilage," said Kenneth E. DeHaven, M.D., professor and associate chairman of the Department of Orthopaedics and director of athletic medicine at the University of Rochester Medical Center, and principal investigator of the study. "While the results look better than with the traditional methods, they have not previously been compared."
The study will evaluate the success of 20 participants, half of whom will be chosen at random to undergo autologous cultured chrondocyte implantation. The other half will be chosen at random to undergo one of the two traditional surgical procedures. The study is open to individuals of either sex, who are 18 to 50 years of age, and who have been diagnosed with a clinically significant articular cartilage defect in an otherwise intact joint. Participants must be willing to make follow-up visits and return for scheduled evaluations.
Individuals interested in participating in the study can call the Department of Orthopaedics at (716) 275-7379.