Repair of trauma-associated cartilage injuries in the knee was feasible and safe using autologous cartilage tissue derived from nasal chondrocytes, Swiss researchers reported.
In a first-in-human phase I study, engineered tissue grafts grown from nasal septum biopsy specimens were successfully secured in the damaged joint in 10 symptomatic patients, and over the course of 2 years, the repair tissue gradually assumed the composition of native cartilage, according to Ivan Martin, PhD, and colleagues from University Hospital Basel.
In addition, mean clinical scores for symptoms, pain, and activities of daily living gradually improved, the researchers reported in the Lancet.
Injuries to articular cartilage are painful and disabling, and can ultimately lead to osteoarthritis (OA) and a need for costly joint replacement.
To assess the feasibility and safety of their novel tissue-based approach, the researchers enrolled 10 patients from 2012 to 2016 who had trauma-induced cartilage lesions ranging from 2 to 6 cm2, located on the femoral condyle or trochlea.
Eight of the patients were men, ages ranged from 19 to 52, and symptom duration ranged from 6 months to 16 years.
Harvesting of the chondrocytes involved a Killian incision in the septum under local anesthesia and obtaining autologous cartilage of 6-mm diameter. In addition, 72 ml of blood was obtained for preparation of serum.
There were no adverse events at the site of tissue biopsy. Over the 24 months of follow-up, two serious adverse events occurred, with one being an injury to the opposite knee and the second being the appearance of new defects at other sites in the same joint.
“In our small cohort of patients for this phase I study, despite the variable degree of defect filling, self-assessment scores and MRI quantitative analyses established a satisfactory clinical outcome and a gradually improving quality of repair tissue over time,” Martin and colleagues wrote.
In an accompanying comment, Nicole Rotter, MD, and Rolf E. Brenner, MD, of the University of Ulm in Germany, wrote that the study “represents an important advance towards less invasive, cell-based repair technologies for articular cartilage defects, because the site of tissue harvest is not located within the healthy part of a joint, avoiding potential side effects of harvesting.”
- Reviewed by Henry A. Solomon, MD, FACP, FACCClinical Associate Professor, Weill Cornell Medical College and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Senior Staff Writer, MedPage Today