Researchers at Massachusetts General Hospital hope a technique using stem cells to enhance joint preservation will help thousands of patients avoid joint replacement surgery. Their work, which shows great promise, has been made possible by the philanthropic support of donors Steven and Alexi Conine.
“We would prefer to stop the deterioration of cartilage in the joint before replacement is necessary.”
Such a joint preservation technique would be welcome news for the 30 million Americans of all ages who suffer from osteoarthritis. The degenerative joint disease commonly affects knees and hips, as well as hands, feet, spine and shoulders. Cartilage in the affected joints wears down over time and its loss is virtually unstoppable. Without cartilage as cushioning, bones rub against bones, causing damage, pain and loss of mobility.
Though most of the seven million Americans who are living with artificial knee or hip replacements are satisfied with the results, “we would prefer to stop the deterioration of cartilage in the joint before replacement is necessary,” says Scott Martin, MD, an orthopedic surgeon and director of Massachusetts General Hospital’s Joint Preservation Service.
Stem Cell Potential
The most promising experimental way to do that is using stem cells, he believes. “Research on stem cells has shown promising results in tissue regeneration, including cartilage regeneration, and may have applications in joints,” Dr. Martin says. He has started a Phase 1 clinical trial to establish the safety of his innovative surgical approach to hip joint repair.
Generous philanthropic support from Steven and Alexi Conine helped Dr. Martin establish his joint restoration program.
Generous philanthropic support from Steven and Alexi Conine helped Dr. Martin establish his joint restoration program. Their support is funding the hip stem cell clinical trial as well as other studies Dr. Martin and his colleagues are conducting to find new methods of joint preservation.
“I look at stem cells as being like children who have a lot of potential,” Dr. Martin says. “But we have to learn how to guide them to do what we want them to do, which is to become cartilage.”
About three years ago, he started using his stem cell technique to do that for patients with chronic tears in their shoulder’s rotator cuff. When that went well, he refined the technique and moved on to the hip. “Our preliminary results have been promising,” Dr. Martin says.
Recipe to Make Cartilage
His recipe contains mesenchymal stem cells (MSCs), adult stem cells that are partially but not fully formed. These stem cells can potentially grow into bone, cartilage or other tissues. He collects the MSCs from the bone marrow of a patient’s hip as well as a solution of platelets from their blood. In the operating room, he repairs injured tissue and then applies the stem cell slurry to the region of injury.
The cells are then formed into a clot. Using surgical techniques he devised to work within the confines of the hip, the clot is returned to the patient’s hip to hopefully replace lost cartilage cells and enhance cartilage repair.
“We are in the early stages of clinical trials using stem cells and it will take time before we fully realize their true potential,” Dr. Martin says.
As a team physician for the New England Patriots and medical director for New England Revolution soccer team, Dr. Martin cares for many patients with sports injuries. They may be among the first to benefit from his new joint preservation techniques.
“But as these techniques get better, there will be no age limits,” he says. “I think they will be applicable no matter what the reason for the wear and tear on the joint.”
He is exceedingly grateful to the Conines for backing his Mass General efforts in joint preservation. “Steve is so much more than a donor,” he adds.
Mindset for Innovation
Steve Conine is the co-founder and co-chairman of Wayfair, Inc., the largest online-only retailer of home goods and his fourth technology start-up. He has a personal interest in joint research. His mother had both hips replaced, his father had his shoulder replaced and, at age 44, Mr. Conine already has cartilage issues in his shoulder.
“I’m impressed,” Mr. Conine says. “It seems to me that Scott Martin and his team have the right approach to come up with solutions.”
“There are great replacement techniques, but it seems like there ought to be other therapies,” he says.
In Dr. Martin and his team, he found people with a similar mindset to driving innovation.
“In our software business we can run experiments quickly to see what works and what doesn’t and learn from mistakes,” explains Mr. Conine, who developed the architecture and software systems that give Wayfair its technological edge. He believes that the Mass General researchers also have a tight feedback loop between research results and application to patient care.
“I’m impressed,” he says. “It seems to me that Scott Martin and his team have the right approach to come up with solutions.”
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