Cartilage Transplant: A New Hope for hopeless!

We have certain tissues in our body like the brain cells which cannot re grow if damaged. A tiny scratch on the skin heals very easily because skin cells re gorw. Similar to the brain cells the cartilage cells once damaged are lost forever. All our joints are lined by cartilage. This cartilage looks exactly like the inner side of a tender coconut i.e. it is smooth, glistening white structure. Normally the cartilage starts showing wear and tear as we age and this disease is a called osteoarthritis. We do accept our aging process but what happens if we loose our cartilage when we are in our twenties or thirties? This can happen due to injuries or accidents. We had no cure for such patients who used to develop osteoarthritis at a very young age. The only treatment for these hopeless patients was a joint replacement surgery. But then we do not have an artificial joint which can last for 40 to 50 years (for a patient in thirties).

We now have a new revolutionary technique where we can grow the cartilage in a laboratory! Let us understand this better by discussing a case study. I recently treated a 40 year old otherwise fit and healthy lady. She had a twisting injury to her knee and started having a lot of pain in her knee. This pain did not subside in spite of rest and medication. Her X-ray did not reveal any fracture. We did a MRI to find out what was wrong and realized that she had lost a fair bit of cartilage form her thigh bone side of the knee joint. We decided to do a cartilage transplant on her. We took a tiny bit of her healthy cartilage from an area of the joint which does not bear the weight. This was done arthroscopically (key hole surgery). She went home on the same day and thee were no stitches. She was asked not to put weight on her affected leg. The cartilage was sent a laboratory in Lonavala. Six weeks later the laboratory gave us a vial of her cartilage cells. These cells were grown using her normal cartilage cells. We then opened her knee joint and filled the crater of cartilage defect with these cells. (The picture below shows the defect in the cartilage at the time of surgery. This surgery is an open surgery and the cut was around 3 inches. The patient went home in 24 hours. It takes 6 weeks for the new cells to re grow the lost cartilage. She was asked to do some exercises and was not allowed to put weight the affected leg. She became totally pain free.

The cost of this procedure is around 1.5 lakhs currently. Initially we had to send the cartilage abroad and the cost was around 30000 US dollars! We now have this facility in India and therefore the cost has come down. The cost of harvesting and reimplanting surgeries is the additional cost involved. Since the cartilage is grown from the patients own cells there is no foreign material implanted and no allergic reactions.

And that’s why this is a new hope for the hopeless!