Engineered cartilage from nasal septum cells is helping treat complex knee damage, according to researchers in Switzerland who have developed the implants.

Their new study shows that giving the cartilage implants more time to mature “significantly” improved clinical efficiency and outcomes—even in patients with complex cartilage injuries, which are painful and seriously limit mobility.

Their work also shows that the method could also be suitable for the treatment of degenerated cartilage in osteoarthritis, says the team from the University of Basel.

They explained that an unlucky fall while playing football or skiing can end an athlete’s career, and such damage to articular cartilage does not heal by itself. It also increases the risk of osteoarthritis.

Researchers at the University Basel Hospital have been working on the new method for several years and can now show that even complex cartilage injuries can be repaired with engineered cells taken from a tiny piece of the patient’s nasal septum cartilage and then allowing them to multiply in the lab on a scaffold made of soft fibers.

The newly grown cartilage is then cut into the required shape and implanted into the knee joint.

Earlier studies have already shown promising results because the nasal cells have particular characteristics that are ideally suited to cartilage regeneration.

“For example, it has emerged that these cells can counteract inflammation in the joints,” said Professor Ivan Martin, who co-led the research with Dr. Marcus Mumme and Professor Andrea Barbero.

In a clinical trial involving 98 participants at clinics in four countries, the team compared two experimental approaches.

One group received cartilage grafts that had matured in the lab for just two days before implantation – similar to other cartilage replacement products. For the other group, the grafts were allowed to mature for two weeks.

During that time, the tissue acquires characteristics similar to native cartilage.

For 24 months after the procedure, the participants self-assessed their well-being and the functionality of the treated knee via questionnaires.

The results, published in the journal Science Translational Medicine, showed a “clear improvement” in both groups.

But patients who received more mature engineered cartilage continued to improve even in the second year following the procedure, overtaking the group with less mature cartilage grafts.

MRI scans further revealed that the more mature cartilage grafts resulted in better tissue composition at the site of the implant, and even of the neighboring cartilage.

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Study co-author Anke Wixmerten emphasized that the longer period of prior maturation is worthwhile. “The additional maturation time of the implant only requires a slight increase in effort and manufacturing costs, and gives much better results.”

Prof. Barbero said it was noteworthy that patients with “larger injuries” benefit from cartilage grafts with the longer prior maturation periods.

“This also applies to cases in which previous cartilage treatments with other techniques have been unsuccessful.”

“If we look at the results from standard questionnaires, patients treated with our approach achieved far higher long-term scores in joint functionality and quality of life,” concluded Prof. Martin.

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