Culturing nasal cells
Q) I read an article in The Times about culturing cartilage from nasal cells in the context of knees. Can it also be used for other joints and if not, why not?
I have severe arthritis in in my left foot and have already had the left knee replaced six years ago, spending six months in plaster with no weight-bearing. Fusion of the joint has been suggested which would mean three months on crutches with no weight-bearing for much of that time and as this is not a practical proposition I have declined.
I thought I had read about culturing cartilage some years ago and wonder why so little progress has been made years: are things more advanced in other countries? What are the chances of getting my problem solved by this process in the foreseeable future and how long are patients who have cartilage grafts immobilised? Is it available to private patients or abroad, if not on the NHS?
If the delay is caused by lack of money, could we not have a massive campaign to raise funds to speed things up? So many people suffer horrendous pain and lack of mobility and painkillers don't help so I feel sure that donations would result if there were a realistic solution in prospect.
Lorna Lancaster, via email
A) I would hate to leave your message on such a low note. Let’s not forget that total joint replacement provides symptom relief for thousands of patients annually and, in my mind, is the most important development in orthopaedic surgery, ever.
Will tissue engineering be the next major step forward? It is too soon to say! However, Arthritis Research UK has made a major investment in tissue engineering setting up a £6 m centre. My old friend Sally Roberts at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Shropshire is leading part of the laboratory side and they have just started their first clinical trial, the
ASCOT (Autologous Stem Cells, Chondrocytes or the Two?) trial, featured in Arthritis Today earlier this year. I would stress, however, that this trial is aimed at people with early osteoarthritis of the knee, not those with established and more advanced disease. If successful, it could be applied to other joints. Back to Surgery advice