Stem cell treatment set for UK tests

A stem cell therapy for osteoarthritis is to be tested on patients for the first time in the UK.

The year-long trial could be the first step towards radical new treatments that avoid the need for joint replacement surgery.

Osteoarthritis affects an estimated eight million people in the UK, a million of whom seek help from their doctor.

The condition is caused by progressive wear-and-tear damage to the surface of the joints, leading to stiffness and pain.

In severe cases the joints have to be replaced with artificial implants.

Each year around 60,000 hip replacements and about the same number of knee replacements are carried out in the UK, almost all of them due to osteoarthritis.

The disease accounts for most of the estimated £5.7 billion a year economic cost to Britain of musculoskeletal conditions.

Stem cell therapy offers the hope of "rebuilding" joints, using an arthritic patient's own immune system-friendly cells.

Plans are now in place for the first early patient trial in the UK of such an approach to tackling osteoarthritis.

The trial, funded by the charity Arthritis Research UK, will use stem cells extracted from bone marrow to repair worn knee cartilage.

Up to 70 people with established knee osteoarthritis will take part in the study, due to be launched at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry, Shropshire, before the end of this year. The trial is part of a £500,000 five-year research programme.

Stem cells are immature undeveloped cells that be turned into different kinds of tissue and grown in the laboratory.

In the trial, mesenchymal stem cells will be removed from the bone marrow using keyhole surgery and grown in the laboratory for three weeks.

They will then be implanted into the area of damage in the hope of forming new cartilage over a period of several months.

Patients will also be treated with cultured cartilage cells called chondocytes - more mature cells that are already used to repair small areas of joint damage, but not osteoarthritis.

Trial leader Professor Sally Roberts, from the University of Keele, said it was important not to see stem cells as a miracle cure.

"Stem cells are portrayed as 'wonder cells' that can do anything, but they can't give you the joints of a 15-year-old," she said.

"At the moment they are not the 'magic bullet' and they don't solve the underlying problem of osteoarthritis, which still needs to be addressed. They have been hyped up. They certainly have huge potential - we just need to learn how to harness it properly."

The patients will be monitored for a year while doctors look at the quality of their knee cartilage and test their ability to perform everyday tasks.

Professor James Richardson, also from Keele, who is co-leading the study, said: "The important thing is to run a randomised trial. If successful, we need to find out if it is cost effective. If a few years can be saved, the benefit to the patient may be not to prevent the need for a joint replacement, but to prevent the need for a revision joint replacement."

Patients taking part in the trial will be recruited from orthopaedic centres around the UK.

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