Engineered nasal cartilage for knee injuries

Sports injuries, such as skiing falls or football collisions, can cause severe cartilage damage. Since articular cartilage does not regenerate naturally, such injuries increase the risk of osteoarthritis. Researchers at the University of Basel and University Hospital Basel have now demonstrated that even complex cartilage injuries can be repaired using replacement tissue grown from the patient’s own nasal cartilage cells. 

The team, led by Professor Ivan Martin, Dr. Marcus Mumme, and Professor Andrea Barbero, has spent years developing this technique. It involves extracting a small piece of nasal septum tissue from the patient, multiplying the cartilage cells in the lab on a soft fiber scaffold, and then shaping the engineered cartilage before implanting it into the damaged knee joint. 

A clinical trial involving 98 participants across four international clinics examined how the maturation time of the implant affects outcomes. One group received cartilage grafts that had matured for only two days before implantation - comparable to existing cartilage replacement techniques. The second group received grafts that had been allowed to mature for two weeks. 

For 24 months post-surgery, participants documented their recovery through self-assessment questionnaires. The results, published in Science Translational Medicine, showed significant improvement in both groups. Notably, patients who received the longer-matured cartilage continued improving in the second year, surpassing the group with the shorter-matured grafts. 

Magnetic resonance imaging (MRI) confirmed that the longer-matured grafts resulted in superior tissue composition at the implant site and even in adjacent cartilage. “The longer period of prior maturation is worthwhile,” emphasizes Anke Wixmerten, co-lead author of the study. She adds that the extra maturation time only slightly increases effort and costs while significantly enhancing results. 

“It is noteworthy that patients with larger injuries benefit from cartilage grafts with longer prior maturation periods,” explains Professor Barbero.  

Professor Martin adds: “Our study did not include a direct comparison with current treatments. However, if we look at the results from standard questionnaires, patients treated with our approach achieved far higher long-term scores in joint functionality and quality of life.” 

Following these findings, researchers at the Department of Biomedicine now plan to evaluate this method for osteoarthritis treatment. Osteoarthritis is a degenerative joint disease that causes cartilage breakdown, leading to chronic pain and impaired mobility. 

MEDICA-tradefair.com; Source: University of Basel