06 August 2019
A new treatment to grow cartilage inside the patient’s knee is being pioneered at Spire Parkway Hospital by Consultant Orthopaedic Surgeon Mr James Arbuthnot.
CartiONE uses the patient’s own cartilage cells to regrow damaged cartilage after being implanted in the damaged knee.
Here Mr Arbuthnot answers some questions about CartiONE, how it works and how it differs from other treatments on offer.
Briefly, what is CartiOne?
This novel technique is intended to repair defects in the cartilage in the joint. It uses the patient’s own cartilage cells, harvested during a surgical procedure, and then combines them with the patient’s bone marrow to produce an activated chondrocyte (cartilage cell) patch to repair the hole in the cartilage. Repairing these defects stops or slows progression to arthritis.
Do you consider this a step forward in relation to other implant treatments such as PRP (Platelet Rich Plasma) injections?
Platelet rich plasma can be used to improve the environment in the degenerate joint and there is good evidence to support its use. It is generally used for more widespread damage. CartiONE uses biological products to repair more localised defects in the cartilage
What are the major advantages of CartiONE?
Several cartilage repair techniques involve two stages/operations with a few weeks gap between procedures. Clearly, if possible we would like to be able to reduce this to one operation.
The technique uses the patient’s own cells in the surgical procedure. These are chondrocytes that are the cells that maintain cartilage. It is a single step procedure. It can be used to treat a range of defect sizes in the knee and there is good evidence it provides long term pain relief.
Is CartiONE suitable for most patients or is replacement surgery sometimes unavoidable?
Replacement is often the best option for end-stage widespread knee arthritis. CartiONE is intended to treat areas of localised cartilage damage and prevent or slow down progression to end-stage arthritis.
How is CartiONE surgery carried out?
Fresh cartilage cells are obtained from the patient’s knee during surgery from areas of the knee that carry less weight. They are prepared by a scientist working with the surgeon in the operating theatre by extracting them from the cartilage samples. These cells are combined with bone marrow cells and usually applied to a patch or “scaffold” that the surgeon then implants into the hole or holes in the cartilage
How long does it take for the implant to grow and take effect?
The cells in the scaffold are fresh and from the patient’s own tissue so they can get to work straight away, but it is usually nine months or more until the repair tissue could be described as “mature”
How long would it be before a patient began to feel the benefits?
Quite often the tidying up or “debridement” of the hole in the cartilage will make the pain in the knee improve quite quickly over the first few weeks, but the true benefits become more apparent over the first six to nine months
Do you envisage CartiONE becoming the ‘go-to’ option for cartilage repair surgery?
The science of cartilage repair is constantly evolving. Knee surgeons have a duty to keep on top of new techniques as they are developed. As the evidence evolves the surgeon can then start to use the techniques which show better and more reliable results.
I believe the role of biologics will develop this area of knee pain management but to surgically repair defects is often necessary and this technique offers a single step solution that is very attractive.
Q: How quickly could I have a consultation and how much would it cost?
A: It depends on the availability of the consultant you wanted to see, but we pride ourselves on getting you fast access to diagnosis and you can often get a consultation within 24/48 hours. Initial consultation fees vary by consultant, but around £175 is a reasonable guide.
You can book online with Mr James Arbuthnot.
Q: If I need surgery, how quickly could I have it?
A: We have no waiting lists at Spire Parkway, but again, it depends on the availability of the consultant you wanted, but as a guide, and subject to your pre-operation assessment, between one and two weeks.
Q: I don’t have health insurance, can I self-pay?