Jab that knocks out the need for key­hole knee op

The Scottish Mail on Sunday - - Health - By Sara Malm

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.’

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