A living bandage made from stem cells, that could optimize the treatment and prognosis for meniscal tears, a common sports knee injury, has been trialed in humans for the first time by scientists at the Universities of Liverpool and Bristol.

More than a million people a year in the US and Europe alone suffer from meniscal tears. They are particularly common in contact sports like football and rugby.

90% or more of these tears occur in the white zone of meniscus which lacks a blood supply, making them difficult to repair. Many professional sports players opt to have the torn tissue removed altogether, risking osteoarthritis in later life.

Knee, Heal Thyself

Developed by the company Azellon, the Cell Bandage is designed to enable the meniscal tear to repair itself by encouraging cell growth in the affected tissue. A prototype version of the bandage was trialed in five patients, aged between 18 and 45, with white-zone meniscal tears.

The procedure involves taking stem cells, harvested from the patient’s own bone marrow, which are then grown for two weeks before being seeded onto a membrane scaffold that helps to deliver the cells into the injured site. The manufactured Cell Bandage is then surgically implanted into the middle of the tear and the cartilage sewn up around the bandage to keep it in place.

All five patients had an intact meniscus 12 months post implantation. By 24 months, three of the five patients retained an intact meniscus and had returned to normal knee functionality whilst the other two patients required surgical removal of the damaged meniscus due to a new tear or return of symptoms.

Encouraging Results

Professor Anthony Hollander, Chair of Stem Cell Biology at the University of Liverpool and Founder and Chief Scientific Officer of Azellon, said:

“The Cell Bandage trial results are very encouraging and offer a potential alternative to surgical removal that will repair the damaged tissue and restore full knee function.

We are currently developing an enhanced version of the Cell Bandage using donor stem cells, which will reduce the cost of the procedure and remove the need for two operations."

Professor Ashley Blom, Head of Orthopaedic Surgery at the University of Bristol, commented:

“The Cell Bandage offers an exciting potential new treatment option for surgeons that could particularly benefit younger patients and athletes by reducing the likelihood of early onset osteoarthritis after meniscectomy."

Repair of torn avascular meniscal cartilage using undifferentiated autologous mesenchymal stem cells: from in vitro optimisation to a first-in-human study Stem Cells Translational Medicine http://dx.doi.org/10.1002/sctm.16-0199

Image: Engineering at Cambridge/Flickr. Human mesenchymal stem cells attached to fibrin. Cell components were fluorescently stained for actin filaments (green) and nuclei (blue). Fibres (red) were imaged in reflectance mode.

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