Using the Nose to Treat Damaged Knees

Researchers are now reporting they have successfully harvested cartilage cells from patients’ own noses to produce cartilage transplants for treating bum knees in 10 adults. All the patients had cartilage that was damaged by injury. Two years after reconstruction, most recipients reported improvements in pain, knee function and quality of life. They also developed repair tissue in their knees that was similar in composition to native cartilage.

Researchers at the University Hospital Basel in Switzerland conducted a phase one study in which they extracted a small biopsy specimen (six millimetres in diameter) from the nasal septum under local anaesthetic. The harvested cells were multiplied by exposing them to growth factors for two weeks. The expanded cells were then seeded onto collagen membranes and cultured for two additional weeks, generating a 30 x 40 millimetre cartilage graft. The engineered graft then was cut into the right shape and used to replace damaged cartilage that was surgically removed from the recipient’s knee.

The study showed that nine out of 10 recipients (one was excluded because of several independent sports injuries) reported substantial improvements in the use of their knee and in the amount of pain compared to before surgery. No adverse reactions were reported.

“Our findings confirm the safety and feasibility of cartilage grafts engineered from nasal cells to repair damaged knee cartilage, but use of this procedure in everyday clinical practice is still a long way off as it requires rigorous assessment of efficacy in larger groups of patients and the development of manufacturing strategies to ensure cost effectiveness,” said lead author Ivan Martin, professor of tissue engineering at the University of Basel and University Hospital Basel in Switzerland.

He said that, while this is was a promising advance and might ultimately help patients with osteoarthritis, much larger studies with longer follow-up were required before this technique could be widely available.

 

Improving Low Level Vision with New Technology

A unique wearable artificial vision device may help people who are legally blind “read” and recognise faces. It may also help these individuals accomplish everyday tasks with significantly greater ease than using traditional assistive reading devices, according to a new study presented at the 120th annual meeting of the American Academy of Ophthalmology.

Millions of older adults have low vision. This sight loss impairs a person’s ability to do simple daily tasks. Optical and electronic devices such as hand-held magnifiers, tele-microscopic glasses and computer and video magnifiers can help. However, these devices are bulky, cumbersome or not readily portable.

Researchers used a device called Orcam My Eye for their study. It clips to glasses, making it hands-free. It features a miniature camera that sees and recognises what the user is viewing, whether text or a face.  It then reads what it is seeing to the user via a small bone-conduction earpiece. The user activates the device by simply pointing a finger to the object or text, tapping it or pressing a trigger button.

Researchers tested the device on 12 legally blind people, who all had a visual acuity of less than 20/200. Study participants performed a 10-item test simulating activities of daily life, including recognising products and reading a variety of items such as emails, letters, newspapers, book and signs. They earned one point for the successful completion of each item, and a zero for each not completed. The total possible score was 10. The researchers observed the participants doing the tasks without the device, then while wearing it after receiving a 90- to 120-minute training session and finally after wearing the device for one week.

They found that, without wearing the device, the participants’ average score was 2.5 out of 10. When they first tried the device, their average score improved to 9.5 out of 10; and after a week of wearing the device the average score of participants improved to 9.8 out of 10.

“While there have been many advances in eye care, the options for assistance in completing daily tasks are limited and cumbersome,” said Dr. Elad Moisseiev, with the Tel Aviv Medical Centre in Israel. “This represents a new step in the evolution of assistance devices for people with low vision, giving them hope for improving their functionality, independence and quality of life.”

 

Medical Minutes by John Schieszer

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.