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A new approach to repairing damaged joint surfaces

Mr Datta Gorav

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Orthopaedic consultant Mr Gorav Datta is leading the ABICUS trial for people with knee or hip pain which is assessing whether cartilage can be repaired using a patient’s own stem cells and provide better outcomes than current treatments.

Known as ABICUS – Autologous Bone Marrow Implantation of Cells University Hospital Southampton – the new technique aims to grow a new joint surface within damaged knees and hips to relieve symptoms of pain and disability.

People suffering with hip or knee pain can be referred to Mr Datta at University Hospital Southampton NHS Foundation Trust for assessment of their eligibility for participation in the trial.

You can read more below, on the ABICUS FAQs page or download the ABICUS trial advert. Should you require any further information please contact Mr Gorav Datta (023 8120 5292), or email gorav.datta@uhs.nhs.uk.

Cartilage damage and joint pain

Cartilage is a tough, flexible tissue that covers the surface of joints and enables bones to slide over one another while reducing friction and acting as a shock absorber.

Damage to this tissue in the knee or hips is common and occurs mainly following sudden twists or direct blows, such as falls or heavy tackles playing sports such as football and rugby, but can also develop over time through gradual wear and tear.

Damage to the articular cartilage (chondral defects) does not heal when injured, leading to exposure of the bone itself, this may increase in size over time leading to increased pain and disability. Untreated, chondral defects may eventually lead to osteoarthritis and patients may ultimately require joint replacements to relieve symptoms.

Comparing current treatment with ABICUS

The ABICUS trial is a clinical trial conducted at University Hospital Southampton NHS Foundation Trust. It is comparing outcomes between the new ABICUS procedure and a conventional procedure used to treat damaged joint surfaces in the hips and knees.

The most common conventional procedure is microfracture whereby holes are made in the exposed bone to stimulate a layer of scar tissue (fibrocartilage) to ‘plug’ the defect. However, this fibrocartilage is not as durable as natural articular cartilage and may degenerate rapidly, leading to re-exposure of the defect and subsequent pain.

The ABICUS procedure uses a patient’s own stem cells to be implanted into the chondral defect via keyhole surgery with the aim of forming a regenerated joint surface and improve symptoms and outcomes. The procedure may be performed in either the hip or the knee.

The nature of the trial

The ABICUS trial is a randomised control trial where participants will be given either microfracture, or the ABICUS procedure as part of their treatment. Which treatment each person receives will be allocated randomly, to ensure a balanced test.

Both procedures are minimally invasive/arthroscopic, or ‘keyhole’, operations.

Microfracture involves making holes in the damaged subchondral bone; this leads to the formation of fibrocartilage which fills the defect in the cartilage.

The ABICUS procedure involves harvesting a patient’s own stem cells using a fine needle from the pelvis. The stem cells are concentrated and then mixed with a matrix of hyaluronic acid and then implanted into the cartilage defect via keyhole surgery.