Biological joints could replace artificial joints soon

January 5, 2011

Artificial joint replacements can drastically change a patient's quality of life. Painful, arthritic knees, shoulders and hips can be replaced with state-of-the-art metal or ceramic implants, eliminating pain and giving a person a new lease on life. But, what if, instead of metal and plastic, doctors were able to take a patient's cells and grow an entirely new joint, replacing the old one with a fully functional biological joint? A team of University of Missouri and Columbia University researchers have found a way to create these biological joints in animals, and they believe biological joint replacements for humans aren't far away.

In a study published this fall in The Lancet, James Cook, a researcher in the MU College of Veterinary Medicine and Dept of Orthopaedic Surgery participated on a research team that created new cartilage in animals using a biological "scaffold" in the animals' joints. Cook assisted with the implant design and performed the surgeries to implant the biologic joint replacements. The study was led by Jeremy Mao of Columbia University.

The scaffold was implanted in rabbits with a surgical technique currently used for shoulder replacement in humans. The surgery removes the entire humeral head, or the ball part of the ball-and-socket shoulder joints. The scaffolds are infused with a growth factor, which encourages the host's own cells, including , to become cartilage and . The advantage to this technique is that it avoids the need to harvest and implant cells, which requires multiple surgeries.

"The device was designed with both biological and mechanical factors in mind," Cook said. "It is unique in design and composition and in how it stimulates the body's own cells. This is the first time we have seen cartilage regeneration using this type of ."

The study found that the rabbits given the infused scaffolds resumed weight-bearing and functional use of their limbs faster and more consistently than those without. Four months later, cartilage had formed in the scaffolds creating a new, functional cartilage surface for the humeral head. The team observed no complications or adverse events after surgery; the new tissue regeneration was associated with excellent limb use and shoulder health, indicating the procedure is both safe and effective.
Cook, who also was involved in the study design and data analysis, said the next step toward FDA approval and clinical use is to study the technique in larger animals.

"If we continue to prove the safety and efficacy of this biologic strategy, then we can get FDA approval for use of this technology for joint replacements in people," Cook said. "We are still in the early phases of this process, but this study gives a big boost to its feasibility."

"We are continuing our concerted efforts in this arena," Cook said. "Our goal at Mizzou's Comparative Orthopaedic Laboratory is to do away with metal and plastic joints, and instead, regenerate a fully functional biologic joint for everyone who needs one. We think this is the future of orthopaedics and we hope that future is starting here and now."

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Quantum_Conundrum
3 / 5 (3) Jan 05, 2011
How exactly is a patient supposed to live for months on end with no limb function while they wait for a joint to re-grow? This would be a totally debilitating, crippling experience for months on end for hip or shoulder replacement, during which the patient will not only be more disabled than they were to begin with, but must also manage to not damage to growing tissues through normal daily activities.

You'd need your arm or leg to be in a ridged cast or exoskeleton to avoid damaging yourself further.
Crossrip
2.3 / 5 (6) Jan 05, 2011
"The team observed no complications or adverse events after surgery; the new tissue regeneration was associated with excellent limb use and shoulder health, indicating the procedure is both safe and effective."
I know maybe we could use stem cells from aborted fetuses to speed up the healing process.
Ricochet
not rated yet Jan 05, 2011
I'm interested to see if they could do something like this for replacement vertebrae.
Jimee
1 / 5 (4) Jan 05, 2011
Good idea, crossrip! Let's begin studying that.
fixer
not rated yet Jan 05, 2011
@ Q.C.
Some of us manage quite well...

It's not going to happen, Stryker biomed bought the patents from Schwartz biomed on Bioduct meniscal replacements and have shown no intent to manufacture as the profit is minimal compared to full knee replacement.

Good idea though.
trekgeek1
4 / 5 (1) Jan 05, 2011

I know maybe we could use stem cells from aborted fetuses to speed up the healing process.


We should. Even people against abortion should be in favor of helping another individual with those cells. Is it better to simply dispose of them, or heal the sick?
Gregor
not rated yet Jan 06, 2011
Ideally, they would simply harvest and convert the patients own cells into stem cells before the procedure. Alien cells risk rejection. It also states that they use the patients own cells in the article.
Crossrip
not rated yet Jan 06, 2011
@Trekgeek. I am not against abortion at all, I am a big fan of stem cell research.
Ricochet
not rated yet Jan 18, 2011
Ideally, they would simply harvest and convert the patients own cells into stem cells before the procedure. Alien cells risk rejection. It also states that they use the patients own cells in the article.


That is an entirely plausible solution, since we figured out how to turn skin cells into stem cells using good 'ole Vitamin C...

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