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As a long-time runner, I am keenly aware that one day my knees will no longer agree to let me run any more. One bout of arthroscopic surgery (to repair torn cartilage) helped, but, for many of us, the knee handwriting is on the wall. Recently, on a trek to climb Kilimanjaro, one member of our team named Jim revealed that he had almost no cartilage in his knee. His climb was his last adventure before a dreaded but essential knee replacement.

Essential? A remarkable innovation, reported in the latest issue of The Economist, by the leading American biotech company Genzyme promises to help those facing aching knees, or knee-joint replacements. Here is the idea:

Genzyme‘s approach takes a small sample of healthy cartilage cells from the damaged knee and uses them to grow millions more cells in a laboratory. The doctors then insert the new cells. In most cases, the implanted cells grow without rejection, since they share an identity with nearby cells. The trial showed that almost a decade after the initial surgery, nearly 90% of the patients who had shown an early positive response to Carticel (about three-quarters of the total) still enjoyed those benefits.

Like all great ideas, one asks – why didn’t they think of that before? Huge resources have been invested fruitlessly in trying to invent artificial cartilage. Cartilage cells, it turns out, are among the most amazing of the body’s cells – able to expand, contract, and grow when needed, cushioning joints and enjoying appreciation only when the cartilage wears away and leaves us with severe pain. Genzyme has found a way to let the body use its own cartilage cells. Potentially millions of people will be eternally grateful.

Blog entries written by Prof. Shlomo Maital

Shlomo Maital
March 2008
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