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Cartilage repair techniques may ease the burden of OA on health services
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The development of novel and more effective treatments of osteoarthritis, such as autologous chondrocyte implantation and matrix-assisted autologous chondrocyte implantation, could lead to a higher quality of life for patients and less of a strain on health services, according to a review for F1000 Medicine Reports.
As average life expectancy increases, osteoarthritis (OA) is poised to become even more of a financial burden on health services. The review, compiled by Yves Henrotin, MsSC, PhD, and Jean-Emile Dubuc, MD, examined the range of therapies currently available for repairing cartilaginous tissue and considered how recent technological developments could affect the treatment of OA in elderly populations.
“The huge financial burden emphasizes the acute need for new and more effective treatments for cartilage defects, especially since there are few disease-modifying drugs or treatments for OA,” Henrotin stated in a Faculty of 1000 Biology and Medicine press release.
The report listed autologous chondrocyte implantation (ACI) as the most promising therapeutic technique.
ACI and Matrix-assisted ACI (MACI) have previously been reserved for younger patients who are not severely obese and have a relatively small cartilage defect with limited success from alternative therapies.
Henrotin stated in the release that the encouraging results of trials cited within the review point toward MACI/ACI therapies possibly being used to delay or even prevent the need for total joint replacement in OA patients.
However, the investigators noted that it remains to be seen whether these techniques are superior in terms of risk and cost-effectiveness when compared with current alternatives.
“ACI/MACI show great promise as treatments for chondral lesions, with a potential for them to be highly cost effective,” the investigators wrote in their review. “But at present this has not been demonstrated and recommendation of this technique for the treatment of cartilage defects in OA joint cannot yet be justified. The superiority of ACI/MACI compared with other OA treatments, such as hyaluronic acid injection or other surgical procedures (debridement, microfractures), needs to be demonstrated.”
The review states that the procedure still needs to be simplified and more specific clinical studies on elderly patients are a necessity. “Further research is needed to simplify the implantation procedure and to improve the success level,” the investigators wrote. “OA patients are generally older and heavier than the population included in the current studies and we lack data on the incidence of failure in this population.”
- References:
Henrotin Y, Dubuc J. Cartilage repair in osteoarthritic patients: Utopia or real opportunity? F1000 Medicine Reports. 2009. 1:88.