New procedure for those that kneed it

A new procedure for knee replacement, in which cultured cartilage cells grow themselves into place, is available now for Australian patients.

Surgeons and scientist from around Australia attended a workshop last week at CTEC, the Surgical Skills Centre at the University of Western Australia, to learn about and practice the new Autologous Chondrocyte Implantation (ACI) technique.

Assoc Prof Ming-Hao Zheng, who helped to develop ACI procedure to treat cartilage defect, said 70,000 Australians suffered from the problem.

University of WA surgeons, in collaboration with German company Verigen International, have set up a $4 million facility for ACI at Hollywood Private Hospital, in Perth. Previously, cartilage had to be sent to Copenhagen, in Denmark, for cell culture.

The ACI procedure involves taking approximately 150mg of cartilage from a patient's knee and growing it for approximately four weeks in the new laboratory. The cultured cells are then implanted back into the knee joint, where they bind to the bone surface and fill the defect in the cartilage.

Post-operatively, the cartilage takes around three months to mature and the patient can then return to work. After 12 months, the cartilage reaches full hardness and the patient is cleared for full activity.

Before ACI, knee replacements used steel and plastic and only lasted for about eight years, said Zheng. The new technique prevents osteo-arthritis, which often develops in artificial knees.

The ACI procedure is covered by private health insurance, and already 60 patients in Australia have had the operation, Zheng said.

He said the benefits included faster recovery time, less invasive surgery with smaller insertions, and prevention of osteo-arthritis.

Zheng said the original technique was developed around 10 years ago. In Australia, the tests on animals for ACI were done at UWA. "Now we want FDA approval" said Zheng, who is a consultant for a one-year study in the US using horses.

Zheng, who has taken the position of chief scientific officer at Verigen, said that down the track the procedure "opens a big door for stem cells and biology areas," which could be used for bone defects and tendon repair. He said that in the future, linear cells could be cryogenically preserved when patients were 15-20 years old, then used for knee replacements when they're older.