Combination of stem cells and surgery could be more effective to treat cartilage damage

Cartilage damage as a result of trauma to the knee is a cause of considerable medical concern. Cartilage damage is associated with significant pain and reduced function, and, as cartilage has a poor ability to heal, patients often develop early and progressive degenerative osteoarthritis.

Due to the pain, reduced function and the concern of early and progressive osteoarthritis development, surgical repair techniques are often considered. These techniques include arthroscopic debridement, where damaged cartilage is removed to reduce pain, bone marrow stimulating procedures including microfracture and arthroscopic abrasion arthroplasty, where surgery at the site of cartilage damage is used to promote bleeding, and cartilage graft techniques. Unfortunately these interventions have inconsistent outcomes, are commonly associated with the formation of scar cartilage and may have limited long-term benefit.

Better understanding of the role of mesenchymal stem cells (MSCs) in tissue repair has seen exciting research developments in the area of regenerative medicine. The ability of stem cells to grow into musculoskeletal tissue, including cartilage, suppress inflammation and stimulate repair pathways has led to exciting research in the area of cartilage damage and arthritis.

In this trial, MSCs were used in combination with arthroscopic abrasion arthroplasty to successfully repair areas of cartilage damage within the knee. During the course of follow-up, treatment with MSCs was shown to be well tolerated and safe. All patients within the trial experienced significant improvement in pain and function. Imaging of the knee throughout the trial period showed progressive structural healing with successful cartilage regeneration. MRI imaging techniques confirmed that the repaired cartilage was comparable to uninjured cartilage.

This trial represents an exciting step in the development of stem cell-based regenerative therapies to assist in tissue repair and is the first trial to show the successful use of MSCs in combination with arthroscopic abrasion arthroplasty to enhance cartilage healing. MSC therapy promises to improve the surgical management of musculoskeletal injuries with improvement in long-term patient outcome.

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