Knee Injuries Nothing to Sniff At: Nasal Cartilage Grafts Used to Help Sore Knees

In small study, doctors used experimental procedure to help aging knees.

October 20, 2016, 7:00 PM
PHOTO: Surgeons are using nasal cartilage to patch up knees in Switzerland, according to a study published in Lancet.
Surgeons are using nasal cartilage to patch up knees in Switzerland, according to a study published in Lancet.
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— -- Millions of Americans suffer from painful knee joints as a result from damaged knee cartilage. Damage can produce severe pain, and if left untreated, it can spread to involve the whole surface of the bone in the knee, which eventually leads to painful and damaging osteoarthritis. But there could be hope: In a new small study published in the Lancet today from Swiss researchers, surgeons are using nasal cartilage to help patch up knees.

Researchers from the University Hospital Basel in Switzerland performed a small study on 10 patients to see if nasal cartilage may help damaged knees.

Helping repair injured knees can be key for keeping adults healthy later in life. Nearly one in two Americans may develop painful knee joints by the time they reach the age of 85. For physically active individuals or professional athletes the damage may start decades before, leading to severe pain.

The researchers extracted cartilage-producing cells called chondrocytes from the noses of patients and seeded them on a collagen membrane in a lab for two weeks. These cells grew into cartilage, which the researchers then grafted into the knees of the patients. They then followed up with nine of the patients for two years to see if they were satisfied with the results and evaluated the quality of the cartilage with imaging. One patient suffered a sports injury during the trial, which necessitated doctors re-doing the procedure, and his results were not included in the final report.

“We’re trying to prevent the onset of osteoarthritis,” Dr. Ivan Martin, study co-author and professor of tissue engineering at the Institute for Surgical Research and Hospital Management at the University Hospital Basel in Switzerland, told ABC News. “For the first time, cells taken from nasal cartilage were transferred to the knee."

Martin said the patients mainly had injuries from recent trauma, including car and ski accidents.

While harvesting cartilage from the knee to then graft onto damaged cartilage is a common procedure in the U.S., nasal cartilage had not been used in this manner before.

Dr. Riley Williams, director of the Institute for Cartilage Repair at Hospital for Special Surgery, associate professor at Weill Cornell Medical College and an orthopedic surgeon who has used cartilage cells from the knee to fix ankles hips and shoulders, said there is potential for this experimental procedure.

“Nasal cartilage is hyaline cartilage same as is found in the knee, so I’m not surprised it would form new hyaline cartilage when transplanted into the knee, so it should over time mature to cartilage-like tissue,” he said.

The researchers found that the cartilage from the nasal septum not only integrated well with the surrounding tissue but also appeared to be better quality in comparison to transplanted knee cartilage.

Martin said that the study is still preliminary and more research needs to be done but that MRI data from the small study shows "the composition of our patients’ [cartilage] is better than reported in other studies.”

The researchers also found that the quality of these nasal cartilage grafts improved over time as the cartilage cells matured.

While the study officially followed patients for up to two years, “The first patient reached three-and-a-half years after the procedure, and they’re still doing very well,” Martin said.

That patient, identified as Salome, told ABC News the procedure has helped her stay active.

“My cartilage damage was quite severe,” said Salome of her knee before the procedure. “Before this operation, I could not do normal work in the household, I could only stand for an hour before my knee swelled up. I can now stand for up to six hours. I now do Zumba!"

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