Introduction to Knee Cartilage Defects in India
The knee bones (ends of the femur and tibia) are capped through a gristle which is termed cartilage. Cartilage is a significant organ because it can withstand a substantial amount of impact and shear-type activities over time. A cartilage defect is a region of impaired or injured cartilage. Cartilage defects can occur due to trauma, osteochondritis, osteonecrosis and other conditions. Cartilage defects are usually seen in the knee joint, where it is frequently caused by trauma and seen in association with ligament injuries, such as anterior cruciate ligament tears.
Small portions of the articular cartilage can break off and float around in the knee as loose bodies which further cause locking, catching and swelling. On the other hand, when cartilage becomes damaged, it is known as chondromalacia, a “kind term” for osteoarthritis. Basically, chondromalacia means cartilage damage on the ends of bones. As soon as damage occurs, it is consistently progressive and results in pain and swelling, which are the major signs of osteoarthritis (OA) and the development of bone spurs and stiffness of the knee over time.
OA affects approx. 27 million Americans while RA affects approx. According to a report generated by the World Health Organization (WHO) 9.6 percent of men and 18.0 percent of women aged over 60 years have symptomatic OA worldwide. In India, the prevalence of OA is 22 percent to 39 percent.
Common Treatments for Knee Cartilage Defects in India
The most common procedures for cartilage restoration include :
* Microfracture
* Drilling
* Abrasion Arthroplasty
* Autologous Chondrocyte Implantation
* Osteochondral Autograft Transplantation
* Osteochondral Allograft Transplantation
Stem Cell Therapy for Knee Cartilage Defects in India
Mesenchymal stem cells (MSCs) are multipotent stem cells that have potential to differentiate into a variety of tissues of the skeletal system and connective tissues such as fat, bone, muscle and cartilage. Several studies identified their differentiation into bone, cartilage, fat, marrow, muscle, skin and tendon. MSCs secrete an enormous range of anti-inflammatory bioactive molecules, cytokines and growth factors.
Basically, multipotent MSCs are initially derived from the embryonic tissue-mesenchyme which is originate from the mesoderm and can be isolated from different sources comprising bone marrow, trabecular bone, periosteum, adipose tissue, skeletal tissues, synovium and deciduous teeth. In vivo, the vital function of MSCs is supposed to be for self-repair and maintaining tissue homeostasis.
The resident MSCs are circulated into the tissues at several stages of maturation and are involved in tissue repair or regeneration. Number of clinical investigators reported on the safety and therapeutic potential of bone marrow derived mesenchymal stem cells (BMSC) administration in patients with OA.
Clinical Studies on MSC Therapy for Knee Cartilage Defects
A study conducted by Nejadnik et al. compares the clinical results of patients treated with first-generation autologous chondrocyte implantation with the patients treated using autologous BMSCs. The clinical outcome was examined before and at several time points after operation via using the International Cartilage Repair Society Cartilage Injury Evaluation Package. Significant improvement was absorbed in patients’ quality of life after cartilage repair in both groups.
The progress in clinical symptoms reported after cartilage repair with BMSCs in the clinical trial by Nejadnik et al is in agreement with clinical results of earlier studies in which clinical symptoms were stated to have improved and repair of cartilage was identified via histopathological evaluation and magnetic resonance imaging (MRI) techniques. In a separate study conducted by Haleem et al stated that autologous BMSCs placed on platelet-rich fibrin glue when administered into the knee of patients with OA lead to complete defect fill and surface congruity with the native cartilage in one patient.
Similarly, according to the study performed by Kasemkijwattana et al indicated improvement in cartilage regrowth in two BMSC-transplanted patients via arthroscopic assessment, which was accompanied with functional recovery. In addition to this, many other studies performed by other investigators demonstrated reduction in pain and also showed some improvement in femoral cartilage volume, albeit in a smaller number of patients. In conclusion, a number of clinical studies explained the potential of mesenchymal stem cells in cartilage repair and regeneration. However, more clinical results are needed to establish stem cells therapy as a therapeutic tool in treating knee cartilage defects.
Conclusion
The use of mesenchymal stem cells in treating knee cartilage defects shows promising results in various clinical studies. Patients have experienced improvements in cartilage repair, pain reduction, and overall knee function. However, more extensive clinical trials are needed to fully establish stem cell therapy in India as a standard treatment option for knee cartilage defects.
MedTravellers is committed to staying at the forefront of medical advancements in orthopedic treatments. We continue to monitor the progress of stem cell therapy for knee cartilage defects and other innovative treatments like Autism, Diabetes, Stroke, Liver Disease, etc. to provide our patients with the most effective and cutting-edge options available.
