New Developments in Joint Replacements

New Developments in Joint Replacements

New, Exciting Techniques Delay Aging

As people live longer, there will inevitably be an increased need for joint replacements One of the major problems encountered by doctors is the fact that, although they have been able to replace joints for a number of years,they have been unable to replace worn-out or damaged cartilage. In fact, if this problem were solved it would enable surgeons to delay joint replacement for a number of years.

According to the BBC, the University College London has been growing cartilage stem cells. In this technique cells are harvested from the patient, grown in a lab and then transplanted back into the patient after joint replacement or to avoid this surgery for as long as possible. Using the patient’s own cells circumvents the need for patients to take immune-suppressant drugs for the rest of their lives. Cells grown from the patient’s own cells also contained higher levels of collagen, the protein constituent of cartilage.

Limitations of the Method

The University College research was led by an Ear and Throat specialist, Dr Archana Vats, She explained that the main problem that led to the search for alternatives was the difficulty for the body to repair or grow new cartilage after injury. The research involved growing human embryonic stem cells with chondrocytes or cartilage cells in Petri dishes in the lab in a specialised system that encouraged them to change into cartilage cells. The process has been tested successfully on mice before being ready to test on humans. When asked about the problems associated with the new technique, she was quoted as saying that “We can take replacement cells from the patient, but there can be problems including accessing cell, damage at the site we take them from – and a limited supply.”

New Research Promises Exciting Results

A new project at the University of Leeds Institute of Medical and Biology aims to address this problem. This project focuses on many of the areas most affected by aging. Besides joint replacement, the research will focus on the spine, teeth, the heart and the circulatory system, Rather than growing the body’s own cells in a lab, the new research aims to use the body’s own regenerative systems. Scientists involved in this latest project have developed a chemical wash that strips cells away from donated cartilage, heart valves, blood vessels or other tissue before they are transplanted into the patient. These stripped body parts then become host to the patient’s own cells in a natural process that takes approximately six months.

Harder-Wearing, Longer-Lasting Joints

In the October 23 issue of The Daily Mail (UK), Jenny Hope, a medical correspondent, reports that around 40 patients have been treated with modified heart valves in yet another study in Brazil.

Reporting on the work of the Leeds study she quotes one of the leading researchers into artificial joints, Professor John Fisher of the Institute of Medical and Biology, as saying that the artificial joints created using this method did not deteriorate and were not rejected by the body. The body accepted these new joints because all the foreign cells had been washed away. This method of removing living cells from human and animal tissue creates a biological scaffold that can be regenerated within the body at the site that needs repairing. Ms Hope writes that “worn out ligaments and knee cartilage can be replaced with a scaffold that will eventually attract new cells to make the joint last longer”.

Replacement Discs and Heart Valves

The new technology can also help people with back problems by replacing discs. Additionally, it can be used to replace tissue in other areas including the knees, shoulders and elbows.

This new research has even more advanced uses. The technology is also being used to create patches to mend damaged heart valves after doctors have cleared blockages in arteries.

Patients Want to Cycle, Play Tennis & Ski

Often people have to wait before receiving their replacement as otherwise the joints will not last till the end of their lives. Often the peripheral pain or secondary effects caused by the wait, result in additional problems in the surrounding tissue and muscle that can impede recovery when the joint is finally replaced. The daily mail report states that Professor Fisher had also designed a ceramic on metal joint that greatly reduces the wear and tear on the artificial joint. As a result people who have joint problems can have them replaced earlier.

Hip replacements have been available for 50 or so years, but while they allow patients to get around and improve their quality of life, they do not allow patients to cycle, or play sports. These new joints will prolong active life. Professor Fisher said that older people nowadays want to be able to cycle, play tennis and ski, so the joints have to last longer.

Cost Effective and Safer

Professor Fisher emphasized that the new method is also cost effective. These new transplants will only cost around 1,000 pounds a time, which was a lot less than growing cells outside the body, he said. Another advantage with this method is that it also reduces the risk of infection, which is much higher in test tube created cells.

However, Professor Eileen Ingham, deputy director of the Institute, stressed that stem cells were not the answer to structural replacement of worn out body parts such as hear valves, reported the newspaper.

(Sources: BBC, Daily Mail (October 23, 2009))