Nasal Septum Cells Pave the Way for Advanced Knee Cartilage Treatments

In a significant advancement in orthopedic medicine, researchers at the University of Basel, in collaboration with University Hospital Basel, have developed innovative cartilage implants using cells sourced from patients' nasal septum. This breakthrough offers a promising solution for repairing articular cartilage injuries, particularly in the knee, which can lead to chronic pain and mobility limitations.

Articular cartilage injuries, common in sports and other physical activities, do not heal naturally and can heighten the risk of developing osteoarthritis. The study published in Science Translational Medicine demonstrates that allowing these engineered cartilage implants to mature before implantation can substantially enhance their effectiveness in treating complex cartilage injuries.

The research team, led by experts in regenerative medicine, has been refining this technique for several years. The process begins with extracting a small sample of cartilage cells from the nasal septum. These cells are then cultivated in a laboratory setting on a biodegradable scaffold made of soft fibers, promoting their growth and maturation. Once adequately developed, the engineered cartilage is shaped and implanted into the knee joint.

Previous studies indicated that nasal septum cells possess unique properties conducive to cartilage regeneration, including the ability to mitigate joint inflammation. The recent clinical trial involved 98 participants across four countries, where two different approaches to cartilage graft maturation were compared. One group received grafts that had matured for just two days, while another group received grafts that matured for two weeks. This additional time allowed the tissue to develop characteristics more akin to natural cartilage.

Participants self-reported their experiences and functional abilities of the treated knee over a period of 24 months. Results indicated improvements in both groups; however, those who received the more mature cartilage grafts exhibited continued progress well into the second year post-surgery. Magnetic resonance imaging (MRI) assessments confirmed that the more mature grafts resulted in superior tissue composition at the implant site, as well as benefits to the surrounding cartilage.

According to the researchers, the extended maturation period for the grafts proved to be worthwhile, requiring only a minor increase in production efforts and costs but yielding significantly better clinical outcomes. Notably, patients with larger cartilage injuries saw pronounced benefits from the more mature grafts, including those who had previously undergone unsuccessful cartilage repair treatments.

While the study did not directly compare these results to existing treatment methods, the data suggest that patients treated with the engineered cartilage approach achieved notably higher scores on joint functionality and overall quality of life assessments.

Building on these promising findings, the research team plans to expand their investigations to include the treatment of osteoarthritis, a degenerative joint disease characterized by the deterioration of cartilage. Upcoming large-scale clinical trials will specifically focus on a form of osteoarthritis affecting the kneecap, known as patellofemoral osteoarthritis. This initiative aligns with the strategic research and innovation priorities of the University of Basel and University Hospital Basel, aiming to advance the field of cellular therapies.