“I got my life back thanks to stem cell research”
Marina (31) was in high school when she walked around the schoolyard with a friend. Suddenly she fell on the ground with both legs in a strange S-shape. Her kneecaps had, for the umpteenth time, been dislocated. “This time it was very serious. I could not put them back myself.” Curious students stood in a circle around her. “At that moment you feel very small.”
Not the first time
Marina was already familiar with dislocation of her kneecaps. From the age of 10 it happened to her, at a misstep, when she turned around in bed at night, or just all of a sudden. “When I was fifteen, it sometimes happened every day.” Everyone was quite used to it, and so was Marina herself. “I just put my own knee back in place: stretch my leg, turn my knee until I heard ‘click’ and then wait for ten minutes. It was part of my life and I did not want my life to be influenced by it.”
Not much to do about it
To give the knee ligaments rest, her legs were put in a cast from hip to foot for six weeks. There was nothing more that could be done about it. “Unstable joints, a girls problem”, was said. “In 2007 I got a constant, burning pain in my knees, I could barely walk or cycle anymore. My life as a student was greatly affected by this. Surgery showed that both knees had very little cartilage. With each movement there is bone to bone rubbing contact with significant damage to the bones as a result.”
2007: two new knee caps
“To stabilize my knees the extensive surgery was very successful but the pain remained. After six months of rehabilitation my other knee was next. A difficult year. I needed help with everything. How do you get your wheelchair up and down if you live on the first floor without an elevator? Fortunately, my parents, boyfriend and friends from the apartment could help.” Marina faced a year of study delay and she had to give up her temporary job. “Thanks to the operations, I had stable knees that stayed in place again. This was a big improvement, but cartilage was still missing and this continued to cause pain”
In 2009 Marina heard about studies at the UMC Utrecht on the repair of cartilage via cell transplantation. She knew that orthopedic surgeon Daniël Saris was working at this and contacted him directly. “I almost begged him to join. But unfortunately that was not possible at first.” However, green light came in March 2009. “I was very happy that I could be treated. During the treatment, a piece of cartilage was first removed from my knee. That was put on culture and grew on a sponge into cells that can make new cartilage. This was put back in the knee. After three months the other knee was also treated. “Another long period of recovery followed. “It was almost unbearable to be so limited and to have to put my life on hold again. Fortunately, the people around me have helped me getting through.”
What Marina had hoped fiercely also happened: the cultured cartilage attached to the places where her cartilage had previously disappeared. “The fact that I can walk again means that I have my life back. Most of the times I even walk without pain, but in some situations my knees are stiff or ache. Like on cold days. I find that no problem and solve it easily. I take a warm shower when I get home and I only choose a warm country as a holiday destination. “
Further study into cartilage transplantation for the knee
The IMPACT method will become our new approach of cartilage transplantation for the knee. An important advantage of this method is that it can be performed in one single operation. No biopsy is taken and the cells do not have to be cultured. This is in contrast to other treatments that require two operations, time to culture cells and a lot of money. Our team of researchers and doctors are dedicated to open up this method to more patients as quickly as possible. The UMC Utrecht strategic programme Regenerative Medicine and Stem Cells in which doctors and researchers work together is important to reach this aim.
IMPACT (Instant MSC Product-related Autologous Chondron Transplantation) means that we start the operation by thoroughly cleaning the cartilage defect, allowing us to recycle the cartilage cells. The cartilage cells are removed and processed in the laboratory. We mix these cartilage cells with bone marrow cells from the donor bank. Then we place the mix of cells back into the damaged area in the knee during the same operation. After this operation the rehabilitation starts. Watch the video about IMPACT.
We expect to be able to treat patients with this experimental method again soon. In the context of this study, there are strict rules about who is eligible. Do you have any questions or would you like more information? Please contact the UMC Utrecht Mobility Clinic and the experts of Regenerative Medicine and Stem Cells via e-mail address: firstname.lastname@example.org