Joints disease are peculiar, their chronic nature and constant pain adds much suffering to a person’s life. Standard conservative therapy presupposes life-long administration of chondroprotectors (chondroitin, glucosamine) and non-steroidal anti-inflammatory drugs. If these medications show low-effectiveness then glucocorticoids are prescribed. However, medicines cannot stop the joint’s cartilage degeneration, but merely help to reduce the symptoms. As a consequence, surgical intervention will be needed sooner or later. Nowadays, the gold standard is endoprosthesis replacement of a damaged joint where artificial mechanical prosthesis is inserted into its place. Most methods of treatment are aimed only at the delaying the need for endoprosthetics.
The world of healthcare is advancing. New treatment methods constantly make their way onto the market. They become a suitable alternative to the endoprosthesis replacement. Such techniques have already been widely implemented in countries like the USA, Germany, and Switzerland. Thanks to medical tourism, it is possible to explore the services of doctors from leading European hospitals to restore cartilaginous tissue of the joints.
Autologous matrix-induced chondrogenesis
Chondrogenesis involves the use of autologous (patient’s own) mesenchymal stem cells for cartilaginous tissue restoration. The true effect of therapy gradually reaches its peak in a year or two. Bones have stem cells inside them. Stem cells are able to turn into any other body cells according to the conditions of their existence. The goals of the treatment is to ensure the penetration of stem cells from the bone into the joint.
The objective of the therapy is:
- Surgery is performed to create defects in the bone tissues.
- Mesenchymal stem cells penetrate into the joint through the defects.
- Defects in the bone tissue are covered by a matrix. They keep blood clots and bone marrow inside. The matrix is usually a membrane of collagen.
Stem cells are gradually differentiating into the chondrocytes. The effect can be enhanced by the use of platelet-rich plasma. It is also possible to penetrate deeper into the bone with the help of Kirschner's needle, which eventually gives a greater yield of mesenchymal cells and improved therapeutic results.
Implantation of autologous chondrocytes
Transplantation of autologous cartilaginous cells is used for defects of cartilaginous tissue of more than 2.5 square centimetres. A modern alternative of this treatment technique involves the implementation of collagen membrane for chondrocytes fixation (surgeries of first generation were using the periosteum).
Essence of the treatment method is:
- A fragment of cartilage is obtained from a patient.
- The fragment is being cultivated until a number of chondrocytes reaches 15-20 million.
- A defect is covered with the collagen membrane.
- Chondrocytes are administered through the hole under the membrane that will be sealed later.
Improved ways of chondrocytes implantation exist that involve the implementation of a matrix for cells’ fixation.
Matrix-induced autologous chondrocytes implantation
BioSeed-C is a service designed to repair a defect in the joint’s cartilage. It is based on combining cell therapy and tissue engineering.
This method of treatment involves:
- A doctor takes a fragment of the unloadable joint cartilage for cultivation. In the process of arthroscopic surgery a diagnosis is performed and the type of the cartilage defect and the accompanying lesions are determined.
- Joint biopsy material is being fermented. It produces chondrocytes – cartilaginous tissue cells which are being cultivated within several weeks. Its aim is to obtain 28.8 million cells.
- Cells are applied onto a bioresorbable 3D matrix. Then, during the second operation, it is implanted into the joint, replacing a cartilaginous defect. This approach ensures the restoration of hyaline cartilage tissue.
Thus, a great amount of cells are grown from the patient’s little cartilage fragment. Cells compensate the deficiency of joint surface and lead to the prolonged remission of the illness from 5 to 10 years. Better results are observed among young patients.
Benefits of BioSeed-C technique are:
- Rejection reaction of the transplant is absent, because own cells are used for the procedure.
- BioSeed-C matrix enables the possibility of an arthroscopic implantation. Such an operation is carried out through tiny incisions. Surgical instruments with a camera are introduced through them, the doctor sees and controls his actions on the monitor. As a result, the tissue damage and the risk of complications are significantly decreased. The rehabilitation period is reduced greatly in comparison with the open surgery.
- The matrix dissolves itself within several months, and the chondrocytes (cells of the cartilaginous tissue) completely fill the defect.
- Accelerated protocol of rehabilitation. Moderate exercise is allowed like running, cycling. Even within 6 months after treatment. Contact sports and almost any high-intensity activities are allowed within 12 months.
- This technique is being carried out in European hospitals. Thousands of patients have already restored their joints thanks to BioSeed-C service.
Disadvantages of the matrix-induced autologous chondrocytes implantation method are: a higher cost and the requirement for two operations. But the results of the treatment justify these drawbacks. At the moment, this is one of the best ways to restore the cartilaginous tissue of the damaged joint.
Choose treatment abroad and you will for sure get the best results!
Author: Dr. Nadezhda Ivanisova