Cartilage repair can improve life, ease burden on health services

Jan 22, 2010

Osteoarthritis (OA) is one of the ten most disabling diseases in the developed world and is set to become more of a financial burden on health services as average life expectancy increases.

OA is the most common form of arthritis, affecting nearly 27 million Americans or 12.1% of the adult population of the United States, according to Laurence et al.¹ A 2001 study showed that the disease costs US about $89.1 billion,2 and indirect costs relating to wages and productivity losses and unplanned home care averaged $4603 per person.3

In a review for F1000 Medicine Reports, Yves Henrotin and Jean-Emile Dubuc examine the range of therapies currently on offer for repairing cartilaginous tissue. They also consider how recent technological developments could affect the treatment of OA in elderly populations.

The most promising therapeutic technique is Autologous Chondrocyte Implantation (ACI), which involves non-invasively removing a small sample of cartilage from a healthy site, isolating and culturing cells, then re-implanting them into the damaged area.

A recent enhancement to this method is matrix-assisted ACI (MACI) - where the cultured cells are fixed within a biomaterial before being implanted to promote a smooth integration with the existing tissues. ACI and MACI have previously been reserved for younger patients who are not severely obese (i.e. with a BMI below 35), whose cartilage defect is relatively small and where other therapies have already been tried.

Professor Henrotin said: "The huge financial burden emphasizes the acute need for new and more effective treatments for articular cartilage defects, especially since there are few disease modifying drugs or treatments for OA."

Given the encouraging results of the trials cited in this review, Henrotin says MACI/ACI therapies could be used to delay or prevent the need for total joint replacement in OA patients. However, it remains to be seen whether these techniques are superior in terms of risk and cost-effectiveness when compared with current alternatives.

While the implantation procedure needs to be simplified, and specific clinical studies on elderly patients are needed, Henrotin is optimistic about improvements currently being researched, and considers that the use of MACI/ACI "constitutes a real opportunity for such patients in the next decade."

Explore further: Researchers discover target for treating dengue fever

More information: References

1. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26-35.

2. Leigh JP, Seavey W, Leistikow B. Estimating the costs of job related arthritis. J Rheumatol. 2001;28(7):1647-1654.

3. White AG, Birnbaum HG, Janagap C, Buteau S, Schein J. Direct and indirect costs of pain therapy for osteoarthritis in an insured population in the United States. J Occup Environ Med. 2008;50(9):998-1005.

Provided by Faculty of 1000: Biology and Medicine

5 /5 (1 vote)
add to favorites email to friend print save as pdf

Related Stories

Emerging techniques put a new twist on ankle repair

Jul 01, 2009

People with ankle injuries who do not respond successfully to initial treatment may have a second chance at recovery, thanks to two new procedures developed to restore the injured area, according to a study ...

Diseased cartilage harbors unique migratory progenitor cells

Apr 02, 2009

A new study finds previously unidentified fibrocartilage-forming progenitor cells in degenerating, diseased human cartilage, but not in cartilage from healthy joints. The research, published by Cell Press in the April 3rd ...

New test to diagnose osteoarthritis early

Aug 20, 2008

A newly developed medical imaging technology may provide doctors with a long-awaited test for early diagnosis of osteoarthritis (OA), scientists from New York reported today at the 236th National Meeting of the American Chemical ...

Protein level may serve as predictor of severe osteoarthritis

Jul 30, 2009

Osteoarthritis (OA), the most common joint disorder throughout the world and a leading cause of disability, is characterized by pain, impaired joint mobility, reduction of muscular strength and loss of joint function. Unlike ...

Recommended for you

Researchers discover target for treating dengue fever

6 hours ago

Two recent papers by a University of Colorado School of Medicine researcher and colleagues may help scientists develop treatments or vaccines for Dengue fever, West Nile virus, Yellow fever, Japanese encephalitis and other ...

Tracking flu levels with Wikipedia

6 hours ago

Can monitoring Wikipedia hits show how many people have the flu? Researchers at Boston Children's Hospital, USA, have developed a method of estimating levels of influenza-like illness in the American population by analysing ...

User comments : 0

More news stories

Turning off depression in the brain

Scientists have traced vulnerability to depression-like behaviors in mice to out-of-balance electrical activity inside neurons of the brain's reward circuit and experimentally reversed it – but there's ...

Hackathon team's GoogolPlex gives Siri extra powers

(Phys.org) —Four freshmen at the University of Pennsylvania have taken Apple's personal assistant Siri to behave as a graduate-level executive assistant which, when asked, is capable of adjusting the temperature ...

Better thermal-imaging lens from waste sulfur

Sulfur left over from refining fossil fuels can be transformed into cheap, lightweight, plastic lenses for infrared devices, including night-vision goggles, a University of Arizona-led international team ...