Topical themes


Some 1.2 million people in the Netherlands suffer from arthrosis (also known as osteoarthritis). This condition is characterized by the wearing away of the cartilage in and around a joint. The patient’s own body is unable to replace the lost cartilage. In most cases arthrosis goes unnoticed until it has reached an advanced stage, when the patient starts to experience chronic pain in the hand, hip or knee. At present, treatment options are limited. Doctors generally rely on pain relief until the joint can be replaced with a prosthetic, if that is indeed possible. Most patients would prefer to avoid the distress and inconvenience of an operation. It may be possible to do so if treatment which helps the body to replace the lost cartilage is started at an early stage. This is the approach now being developed by the Tissue Regeneration department, part of the University of Twente’s MIRA Institute.

Active gel
The MIRA research group led by Dr Marcel Karperien is working to perfect a new 'hydrogel'. This material can be injected directly into the knee at the precise point at which the cartilage is eroded. The gel forms a protective layer on the affected bone surface, thus minimizing further damage. However, the gel can do more than merely protect. Various tests have been conducted in which the gel has been enriched with 'new cells' which promote the natural regeneration of cartilage. Both cartilage cells and stem cells have been shown to be effective. MIRA is now working on a similar approach for use in patients with arthrosis of the hand.

Early diagnosis
As in most conditions, it is essential to diagnose arthrosis at the earliest possible stage. Doing so will not only avoid unnecessary pain and suffering, but will increase the likelihood of successful treatment using the hydrogel. Unfortunately, early-stage arthrosis has few symptoms. To facilitate early diagnosis, the Tissue Regeneration department has therefore developed 'biomarkers': measurable indicators in the body which provide a warning when cells begin to degenerate. Using these biomarkers, doctors will be able to spot any problem far sooner and begin the new treatment promptly.