Allogeneic MCSs to make Cartilage for Knee Function

Allogeneic MCSs to make Cartilage for Knee Function    INTRODUCTION: – 1.1 What is Osteoarthritis? Articular cartilage is a highly resilient hyaline tissue composed of chondrocytes and surrounded by extracellular matrix present in a joint which act as shock absorber, protects the bones from the friction and wear and helps in smooth movement of the joint (Bhumiratana et al. 2014). Osteoarthritis is a disease of joint where lack of cartilage causes musculoskeletal pain and restriction of the movement or disability of the joint for the patient. (Ahmed and Hincke, 2010) (Duthey, 2015). Reasons for cartilage damage are: – The impact / blow caused during sport activities or accident Wear and tear because of overuse of a joint (Observed in elderly people) Lack of movement (Medical News Today, 2017) Figure No.1. Osteoarthritis Affected Region Image Source: – www.osteoosteoOsteoarthritisresearchuk.org Osteoarthritis can affect any joint present in the body. As the knee-joint Osteoarthritis is the most commo n type of Osteoarthritis, in this report, we will discuss about knee-joint Osteoarthritis only. Tibiofemoral and patellofemoral are the two articular surfaces that the knee consists of. As it can be seen in the below image, the damaged cartilage, reduces the gap between joint and friction is generated between the bones which ultimately results in bone erosion and causes muscle pain or inflammation or restriction to the movement. Figure No.2. Osteoarthritis affected Knee Image Source: – http://www.bupa.co.uk/health-information/directory/o/Osteoarthritis Osteoarthritis is estimated to affect 250 million people worldwide. Osteoarthritis sufferers include men and women, children and adults. And according to World Health Organization, 30% of men and women over the age of 65 have Osteoarthritis (Woolf and Pfleger, 2003). Worldwide, 9.6% of men and 18.0% of women over the age of 60 years have symptomatic Osteoarthritis. Approximately 80% of those with Osteoarthritis will have limit ations in movement, and 25% cannot perform their major activities of daily life (Duthey, 2015). Figure No.3. Prevalence of Osteoarthritis of Knee Image Source: – Burden of major musculoskeletal conditions, Bulletin of the WHO 2003 1.2 Treatments available for Osteoarthritis: – There are various ways to cure Osteoarthritis when it is at the initial level, such as: – Exercise and weight loss Bracing Medication Viscosupplementation Nutritional supplements (Duthey, 2015). But when it becomes incurable by exercise and medication, surgical operations must be performed. Surgical procedures include: – Debridement i.e. Smoothening of the cartilage using surgical instruments Marrow Stimulation, a treatment which helps in regrowth of cartilage in the joint (but this process is less reliable) (Treatment Options for Osteoarthritis in the Knee, 2017). Mosaicplasty, a process where the cartilage from some other joint of body is used. But this process h as size limitations (Medical News Today, 2017). Autologous Chondrocyte Implantation, a treatment in which a small part of no-load bearing cartilage is removed from the joint of the patient by Arthroscopy, regrown and multiplied in the laboratory and then implanted back in the body by a procedure called arthrotomy. (Cartilage Repair, 2017) (Ahmed and Hincke, 2010) (Duthey, 2015). Even though the Autologous Chondrocyte Implantation seems effective and easy, it has many disadvantages such as: – The patient’s cartilage sample must be removed by a medical procedure, marked/tagged and treated separately just like blood sample. This treatment requires big Logistics and Supply Chain. It requires a lot of time (approximately 6 weeks) for cells to multiply. Hence, till then the patient will suffer from pain (Peretti et al. 2000). 1.3 Proposed Treatment for Osteoarthritis: –