By: 19 December 2013

Single operation will cut treatment time and costs

 OPN157NewsThe Orthopaedics department at UMC Utrecht in the Netherlands has developed a new one-step procedure to remove cartilage cells surgically from the damaged knee and mix them with specially selected donor stem cells. The cell mixture is then applied to the damaged area in the knee during the same operation. The advantage for patients is that only one procedure is required instead of the usual two operations at an interval of three months. The new surgical technique will be less of a burden on patients, treatment time will be cut and costs may fall by as much as 75%.
Cartilage damage in the knee is seen relatively often in active people, both young and middle aged. As cartilage is not perfused, any damage it incurs does not heal spontaneously. Cartilage damage can be painful and become a permanent hindrance to daily activities and exercise. It can also lead to further wear of the knee and invalidity.

Some patients are eligible for a cartilage transplant, but although this treatment is effective, it is an expensive procedure requiring two operations: one for taking a biopsy to harvest cartilage cells to be cultured, and a second operation three months later to place the cultured cartilage back in the knee. With this new technique, the surgeon removes the damaged cartilage edges and mixes the patient’s own cartilage cells with selected donor stem cells and tissue glue. This makes the time-consuming culturing of cartilage redundant. The mixture is immediately placed back in the knee, after which the damage repairs itself and the patient can recover.

Orthopaedic surgeon Professor Daniël Saris, pictured, of UMC Utrecht, explains: “This new procedure is called Instant MSC Product accompanying Autologous Chondron Transplantation (IMPACT) and is the result of innovative patient-targeted research conducted as part of UMC Utrecht’s key Regenerative Medicine and Stem Cell Research. We are working very closely with the cell therapy facility of UMC Utrecht, one of the few facilities in the Netherlands that is capable of preparing such cell products, which gives us the unique opportunity to work as a team to convert clinical and scientific expertise into a viable cell therapy.”

 The IMPACT project is supported by various prestigious subsidies including the ZonMW stem cell grant, which is aimed at breakthrough projects that fit into the Regenerative Medicine programme of the Netherlands’ Life Sciences & Health top economic sector. ZonMW is the Netherlands Organisation for Health Research and Development. In total, approximately €1 million has been made available, which, given the advantages this procedure offers, is a relatively small investment. Professor Saris explains, “Simple mathematics shows us that we can save about €2 million for every 100 patients because our method costs approximately 75% less than the current autologous cartilage implantation. Taking the indirect costs (ie those related to sick leave) into account, cost savings will be even higher. The first few patients have already undergone this unique operation. If the safety and effectiveness of this new method is confirmed in the ongoing clinical study, this could have an enormous impact on the cost-effectiveness of these types of treatments.”

Junior editor at Fintech Intel