One subject among my weekly e-briefs which consistently generates a lot of feedback is related to knees. One thing baby boomers have in common is the need for joint replacements. The number of hip and knee replacements in the U.S. is roughly one million per year, 2/3 of which are knees. Over the years ahead, projections indicate there may not be enough surgeons to handle the rapidly growing demand. In many cases, the need for the replacement comes from overuse, injury, or osteoarthritis that led to destruction of cartilage, the flexible connective tissue in hip, shoulder, and knee joints. The common phrase uttered by those facing the joint replacement is “I am down to bone on bone”. All this will change with the development of artificial cartilage and 3D Printing. The 3D printers are quite advanced and able to print body parts using specialized cells as the “ink”. Every week, I see something new in the development of artificial cartilage.The ultimate solution will likely come from cells in our own bodies.
Determining the number of cells in the human body is not easy. If you base the number on volume, you get an estimate of 15 trillion cells. If you estimate based on weight, you end up with 70 trillion. The consensus is 37 trillion. The cells of increasingly intense interest are stem calls. Stem cells are capable of giving rise to indefinitely more cells of the same type. Even more interesting are pluripotent stem cells, often called master cells. Pluripotent stem cells can be induced to produce any cell or tissue the body needs to repair itself.
Even more specific are mesenchymal stem cells (MSCs), which are cells which can morph into a variety of cell types, including osteoblasts (bone cells), chondrocytes (cartilage cells), myocytes (muscle cells) and adipocytes (fat cells which give rise to marrow adipose tissue). The MSCs are adult stem cells traditionally found in the bone marrow.
Eighteen stories here on johnpatrick.com have discussed or referred to artificial cartilage, but all have seemed distant. That perception is changing fast. A group of researchers at Osaka University in Japan has developed a synthetic tissue using MSCs for treatment of damaged cartilage. The Medical Center for Translational Research (MTR) has performed surgery on the first patient in a Phase III clinical study to confirm efficacy and safety of the therapy. This is the first clinical trial of regenerative therapy in Japan using stem cells.
The number of patients with potential osteoarthritis (OA) is estimated to be about 30 million. The potential for a safe and cost effective treatment option is now in sight. I will be following the results of this exciting clinical trial. Read more about the Osaka University clinical trial here. Read more about regenerative medicine in Health Attitude: Unraveling and Solving the Complexities of Healthcare.