Jab that knocks out the need for keyhole knee op

ASINGLE injection of protein harvested from a patient’s own blood may replace the need for knee surgery for osteoarthritis sufferers. The new 20-minute procedure sees blood drawn from the patient’s arm, separated in a centrifuge, after which part of the fluid is then injected into the arthritic knee. The surgeon who brought the treatment to the UK believes it can stop the need for keyhole surgery for osteoarthritis of the knee altogether.

Osteoarthritis is the most common type of arthritis, particularly affecting people aged 65 and over. The degenerative condition affects the cartilage – the joint’s connective tissue – causing pain, stiffness and inflammation.

A trial study in the Netherlands published earlier this year showed that 85 per cent of patients had little to no pain in their knee six months after new procedure, which is called the NStride Autologous protein injection.

A further, larger, study based on work in Italy, Austria, Belgium and Norway, which has seen similarly positive results, is due to be published later this month.

The theory behind the new procedure is that the inflammation caused by arthritis can be combated by injecting healthy proteins straight into the joint. About 55ml of blood is taken from a vein in the patient’s arm, mixed with an anticoagulant and centrifuged at high speed for 15 minutes, causing the blood to separate into three layers – a yellow blood plasma; a red blood cell concentration; and a ‘platelet-rich plasma’, a solution comprising platelet cells and some white blood cells.

The platelet-rich plasma is extracted and centrifuged again for an additional two minutes until surgeons end up with a 3ml protein liquid, which is then injected into the knee.

VIKAS Vedi, consultant orthopaedic surgeon and specialist in hip and knee reconstruction at BMI Bishops Wood Hospital in Northwood, North-West London, is the first consultant to perform the procedure in the UK.

He has treated five patients since May, and so far the treatment has improved the condition of all patients, but Mr Vedi will be monitoring their progress for the next three years.

Each injection costs £1,800 and the procedure is available only from Mr Vedi at present.

‘The aim is a clinical improvement in the patients’ osteoarthritis as well as an improvement in quality of life,’ he says.

‘There is also additional evidence within animal studies that the reported symptoms of osteoarthritis are actually reversed.

‘The aim is that this will stop the need for arthroscopy – keyhole surgery – in patients with arthritis as we know that this is not very effective.’

Robert Kirby, 64, from Watford, is one of the first Britons to have the injection.

‘I have had arthritis for eight years, but it wasn’t that painful until last year,’ he says.

‘I had keyhole surgery in both knees by Mr Vedi and it became apparent that there was no cartilage at all in my left knee and bones was grinding on bones.

‘The plan was to have a complete knee replacement, but then Mr Vedi told me about this new treatment.

‘The procedure was very quick – it felt a bit like injecting oil into the knee – and it was all over in just 20 minutes.

‘I was advised to rest the knee for the first two weeks, so took time off work. I am a mechanical engineer so I am on my feet all day, and at the end of my first day back the knee was a bit sore and swollen, but that was it. I can’t be sure if this is going to rule out a knee replacement in the future, but so far it’s going well.’