Cartilage stem cell treatment arrives in Capital

Itra Singh turned 18 on February 11. The day gained another significance in her life as she became the first patient in any Delhi government hospital to be treated with a third generation stem cell technology for her knee joint injury.

Her operation was shown live to orthopedic surgeons at the annual event, 3rd Maulana Azad Medical College Arthroscopy and Sports Injury Update. The theme of the conference was ‘preservation of meniscus and cartilage’.

“India does not have facilities to culture stem cells, at least of cartilage. Doctors are not even aware of such procedures. With this exercise we are trying to build awareness to get the latest technology in the country,”  said Dr Vinod Kumar, head, sports injury unit of orthopedics department.

The government announced that facilities in the orthopedics department will be improved and new technology will be introduced. It was on a fine day in August 2011 that Itra’s leg twisted while dancing at her house in Muzaffarnagar, Uttar Pradesh.

“We heard a crack. Local doctors thought it was a ligament injury. As she was not getting well, we came to Lok Nayak Hospital,” said Itra’s mother.

The diagnosis at the orthopaedics department of LNJP, was that the bone at her knee joint was broken, creating a 4-sqcm crater of 5 mm depth.

“It was a crucial part of the joint, which takes all the burden of the body. At a young age, joint replacement or any other surgery would have hampered many of her activities,” said Dr Kumar.

In a procedure called ‘autologous chondrocyte implantation’, stem cells from her cartilage were taken and sent to South Korea for culture by a private company.

“This treatment was meant to the show latest technique in cartilage preservation. It cost Rs 60,000, which was an exception as it was happening for the first time. The cost otherwise is Rs 1.75 lakh at the moment,” said Dr Kumar.

Once the cultured stem cells arrived, they were injected inside Itra’s injured joint. Now she is going through physiotherapy and will be discharged in two weeks.

“Certain cartilages, including that of the knee joint, do not have blood vessels and thus, cannot grow again like bones,” said Dr Kumar.

The first generation stem cell implants were not effective due to covering of a membrane through which the cells used to slip out. Even the second generation technology had similar problems, though to a lesser extent.

“In third generation stem cell implant, a glue is mixed with the cells that binds them together and also increases the process of multiplying of the cells,” said Dr Kumar.  
  
The procedure is approved by the US Food and Drug Administration. In absence of any guidelines by the Indian government, doctors depend on FDA’s guidelines.