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Hip replacements might provide “untapped” source of stem cells for regenerative medicine

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In a study just published in STEM CELLS Translational Medicine, researchers have found what might prove to be a rich new source of adult stem cells for use in regenerative medicine — the tissue normally discarded during routine hip replacement surgery. With well over 300,000 hip replacements taking place each year in the United States alone, according to the Centers for Disease Control, this tissue might provide an unprecedented source of autologous stem cells for aging patients and have “profound implications” in clinical use, the scientists say.

“In hip replacement surgery, the femoral head and part of the neck are resected to accommodate the neck of the implant. Typically this tissue is discarded, yet it may provide an untapped source of autologous stem cells for aging adults who were born a generation too early to benefit from banking of tissues like umbilical cord blood at birth,” said Melissa Knothe Tate, Ph.D., of the University of New South Wales (UNSW) in Sydney , the leader of the study. Teaming with an orthopedic surgeon, Dr. Ulf Knothe of the Cleveland Clinic in Cleveland, the Institutional Review Board-approved study was a global effort with scientists from Ludwig Maximilians University in Munich and Case Western Reserve University in Cleveland.

The aim of the study was to determine the feasibility of using the patient’s own tissue removed during routine joint replacement to potentially heal and/or repair failing organs and to treat diseases. The team collected cells from the periosteum, a fibrous membrane of connective tissue that snugly covers all bones, of patients with rheumatoid arthritis (RA) or osteoarthritis (OA) who underwent hip replacement surgery. These periosteum derived cells (PDCs), from patients ranging in age from 30 to 72 years, were compared with commercial bone marrow stem cells derived from prenatal donors on up to 72-years-old of undetermined health.

Based on the results, the PDCs exhibited “remarkable similarities” to the bone marrow cells cultured under identical laboratory conditions. They also showed “no significant differences” in their ability to differentiate into other cells due to the donor’s age or disease state.

“The use of periosteum tissue that is discarded with the femoral neck in replacing the hip is highly novel, as it represents an unprecedented and to date unstudied source of stem cells from OA and RA patients,” Dr. Knothe Tate and her team noted further.

Dr. Ulf Knothe, the leading clinical scientist on the study, concluded, “Use of stem cells from periosteum may open up unprecedented opportunities for the treatment of disease and tissue/organ failure in aging osteoarthritic patients who are increasingly in need of novel therapeutic interventions.” 

“This study, believed to be the first to show the feasibility of isolating cells from periosteal tissue, suggests a potential new source of cells for patients’ future use, said Anthony Atala, M.D., editor of STEM CELLS Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine. “Of course, followup studies must address how banking affects cell viability.”