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Clinical trial assessing stem cell ‘living bandage’ for knee injuries under way in humans

A "living bandage" made from stem cells, which could revolutionize the treatment and prognosis of a common sporting knee injury, has been tested in humans for the first time by scientists at the Universities of Liverpool and Bristol. The bandage might reduce the likelihood of early onset osteoarthritis after meniscectomy, its developers believe.

Meniscal tears are suffered by over 1 million people a year in the United States and Europe alone and are particularly common in contact sports like football and rugby. Ninety percent or more of tears occur in the white zone of meniscus, which lacks a blood supply, making them difficult to repair. Many professional sports players opt to have the torn tissue removed altogether, risking osteoarthritis in later life. The cell bandage is designed to enable the meniscal tear to repair itself by encouraging cell growth in the affected tissue.

A prototype version of the cell bandage was tested in five patients, aged 18 to 45, with white-zone meniscal tears. The trial received funding support from Innovate UK and the promising results were published last week in Stem Cells Translational Medicine.

The procedure involved taking stem cells, harvested from the patient's own bone marrow, which were then grown for two weeks before being seeded onto a membrane scaffold that helps to deliver the cells into the injured site. The manufactured cell bandage was then surgically implanted into the middle of the tear and the cartilage was sewn up around the bandage to keep it in place.

All five patients had an intact meniscus 12 months post-implantation. By 24 months, three of the five patients retained an intact meniscus and had returned to normal knee functionality while the other two patients required surgical removal of the damaged meniscus due to a new tear or return of symptoms.

Anthony Hollander, Ph.D., chair of stem cell biology at the University of Liverpool and founder and chief scientific officer of Azellon, which developed the cell bandage, called the trial results "very encouraging," adding that they "offer a potential alternative to surgical removal that will repair the damaged tissue and restore full knee function."

The team is currently developing an enhanced version of the cell bandage using donor stem cells, which they expect will reduce the cost of the procedure and remove the need for two operations.

The cell bandage was produced by the Advanced Therapies Unit at the NHS Blood & Transplant facility in Speke, Liverpool and implanted into patients at Southmead Hospital in Bristol, under the supervision of Ashley Blom, M.D., Ph.D., head of orthopedic surgery at the University of Bristol.

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DOI: 10.1002/sctm.16-0199