Cartilage Tissue from Cells of the Nasal Septum Helps in the Treatment of Complex Knee Injuries

Injuries to the articular cartilage in various joints, including the knee, are painful and restrict mobility. Researchers at the University of Basel and the University Hospital Basel are therefore developing cartilage implants made from cells taken from the patient’s nasal septum. A recent study shows that a longer maturation time for these cartilage implants significantly improves clinical efficacy, even in patients with complex cartilage injuries. This suggests that the method could also be suitable for treating degenerated cartilage in osteoarthritis.

How Nasal Septum Cells Can Heal Even Difficult Cartilage Injuries

An unfortunate fall while skiing or playing soccer can put an end to sporting activities. Damage to joint cartilage does not heal by itself and increases the risk of osteoarthritis. Researchers at the University of Basel and the University Hospital Basel have now shown that even complex cartilage injuries can be repaired with replacement cartilage from cells of the nasal septum.

A team led by Professor Ivan Martin, Dr. Marcus Mumme and Professor Andrea Barbero has been developing this method for several years. The cells are taken from a tiny piece of the patient’s nasal septum cartilage and then allowed to multiply in the laboratory on a scaffold of soft fibers. Finally, the newly grown cartilage is cut into the desired shape and implanted into the knee joint. Earlier studies have already shown promising results. “Nasal septum cartilage cells have special properties that are ideal for cartilage regeneration,” explains Professor Martin. For example, these cells have been shown to be able to counteract inflammation in the joints.

More Mature Cartilage Shows Better Results

In a clinical study involving 98 participants at hospitals in four countries, the researchers compared two experimental approaches. One group received cartilage transplants that had been aged in the laboratory for only two days before implantation – similar to other cartilage replacement products. The other group received transplants that had been aged for two weeks. During this time, the tissue takes on properties similar to those of natural cartilage.

After the procedure, the participants used questionnaires to assess their well-being and the functionality of the treated knee for 24 months. The results, published in the journal Science Translational Medicine, showed significant improvement in both groups. However, in the patients who had received more mature artificial cartilage, the improvement continued into the second year after the procedure, overtaking the group with less mature cartilage grafts.

Magnetic resonance imaging (MRI) also showed that the more mature cartilage transplants led to better tissue composition at the implantation site and even in the neighboring cartilage. “The longer maturing period in advance is worthwhile,” emphasizes Anke Wixmerten, co-lead author of the study. The additional maturation time of the implant, she emphasizes, requires only a small amount of additional effort and higher manufacturing costs and leads to much better results.

Particularly Suitable for Larger and More Complex Cartilage Injuries

According to the researchers, it is noteworthy that patients with larger injuries of cartilage transplants benefit from longer previous maturation times. This also applies to cases in which previous cartilage treatments using other techniques were unsuccessful. The researchers’ study did not include a direct comparison with current treatment methods. However, when looking at the results of standard questionnaires, the patients treated with their approach achieved far higher scores in terms of joint functionality and quality of life in the long term. Based on these and earlier findings, researchers at the Department of Biomedicine are now planning to test this method for the treatment of osteoarthritis – an inflammatory disease that causes degeneration of joint cartilage and results in chronic pain and disability.

Two large-scale clinical trials, funded by the Swiss National Science Foundation and the EU research framework program Horizon Europe, are about to begin. These studies will evaluate the technique’s effectiveness in treating a specific form of osteoarthritis affecting the kneecaps (i.e., patellofemoral osteoarthritis). The activities will further develop the field of cellular therapies in Basel, which has been strategically defined as a research and innovation focus area at the University of Basel and University Hospital Basel.