Patients suffer from chronic pain in affected joints, combined with worsening disability as the disease progresses and movement becomes more and more difficult. Joint replacement, particularly of hips and knees, has been the most common approach and, although very effective, is generally indicated late in the disease process when both joint damage and pain are severe. 

Early stage treatments aim to repair cartilage using cells as a therapy, or as a target for a molecule - similar to the active ingredient in a drug treatment. Key to the success of this approach is a detailed understanding of the cells involved, whether from bone marrow or peripheral blood. This is the aim of the project that has been funded over the last two years by the Evelyn Trust and is being led by Professor Andrew McCaskie, Professor of Orthopaedic Surgery at the University of Cambridge. The research is due to be completed in 2017.

“Our ultimate aim is to find ways to encourage cells to regenerate cartilage using cell therapy, or by stimulating cells to do this repair work using drug treatments. But we need to identify the populations of stem cells and blood-forming cells that have the most potential. We’ve not previously been able to determine which is the best cell type for treatment, or the best method of bioprocessing and so we are also evaluating clinical cell acquisition methods. We are increasing our understanding of cell selection and bioprocessing using cell phenotyping which gives us essential information about cell morphology and function. If we can differentiate between cells, we can examine how their behaviour differs and how they may work together. This is vital, fundamental research that is critical for the development of successful treatment for the early stages of osteoarthritis,” explains Professor McCaskie.

The results of this research will be important addition to several related translational programmes in musculoskeletal regenerative science across Cambridge. Professor McCaskie has a long-term ambition to develop a ‘Cambridge Movement Centre’ with clinical and research partners. This multi-disciplinary centre will focus on relieving pain and restoring movement in patients, and will deliver excellence both in the delivery of current treatments and the development of treatments for the future. This would feature a strong focus on engagement and outreach to improve disease management and quality of life.

“The burden of osteoarthritis on patients, families and the NHS should not be underestimated. There are many promising ideas and strategies across a range of disciplines and if we bring them all together, putting the patient at the centre of our planning, we will have a much greater chance of impact and transformation in the years to come.”