Health and Research
25th November 2024
A new cell based treatment to repair joints in the early stages of osteoarthritis (OA) is now available on the NHS. The treatment is called Autologous Chondrocyte Implantation (ACI) and involves using stem cells harvested from the patient’s own body to rebuild damaged cartilage.
Our joints undergo constant maintenance and repair to keep them mobile and supportive. When the cartilage that lines and cushions the joints is damaged in OA, the cartilage cells (called chondrocytes) can no longer heal properly. This leads to persistent and painful damage and inflammation in the affected joints. The pain and stiffness associated with OA can significantly reduce mobility and quality of life.
Traditional approaches to managing OA are more about controlling the symptoms than treating the disease: management of pain and inflammation and muscle strengthening through physiotherapy. Joint replacement can be a good option in more advanced OA, but there are risks associated with the surgery, and it’s not always effective. Artificial joints only last for around 20 years too, so if replaced in younger patients, then multiple surgeries/replacements are needed.
The newly available ACI therapy is a true treatment in that it is designed to directly repair the damaged cartilage. In the procedure, a small tissue sample is taken from the affected joint and used to grow new cartilage cells in a laboratory. After around three weeks of growing, the new cells are added to the joint's damaged area, where they form new cartilage.
ACI usually involves staying in the hospital for a couple of days for the treatment and then, as an out-patient, following a physiotherapy/rehabilitation programme. Within three months, full use of the ACI-treated joint for typical daily activities should be possible. About a year after treatment, more vigorous activities and exercise can be resumed.
Research shows that ACI can significantly improve OA symptoms: reducing pain and increasing mobility and function. There’s also evidence that ACI can slow/stop the progression of OA and can delay or remove the need for joint replacement. The reduced need for surgery makes it especially helpful for younger people in the early stages of OA.
OA affects around 10 million people in the UK. We know from our 1000 Voices research that people with spina bifida are more at risk of OA and of developing it at a younger age than the wider population: 9% of our members aged 25-30 said they had osteoarthritis, rising steadily to 59% of those over age 71. ACI therapy has the potential to help a lot of people in the early stages of OA, including Shine members.
In line with NICE guidelines, ACI is available on the NHS to those with early OA or small areas of cartilage damage. To find out more about the possibility of being referred for an ACI assessment, speak to your GP or orthopaedic/rheumatology consultant.
ACI is proving to be a very effective treatment, but research hasn’t stopped there. A clinical study called ASCOT is underway to determine whether stem cells can be used in a similar way to cartilage cells and whether stem cells work better alone or if using cartilage cells and stem cells together works best. It’s an exciting study and will hopefully mean even better treatments on the horizon for osteoarthritis.