Genzyme

In this procedure cells are grown from a patient's joint cartilage, and then returned to the patient to replace damaged cartilage. 'Carticel' is the trade name given to the cell culture returned to the surgeon from the laboratory.

The Genzyme technique is a newer addition to the surgeon's portfolio of arthritis treatment regimes. It is a two-stage procedure and involves the patient having a minor procedure to take from the joint a small sample of normal joint gristle ('hyaline or joint cartilage'). This is sent to a laboratory for tissue culture, where the volume of cells is greatly increased. At the second surgical procedure, which is a bigger procedure, the cells are placed into the arthritis part of the joint surface and held in place by a retaining membrane also taken from the patient's body.

Although this procedure is complex, it has a number of advantages - firstly all the cells are from the patient themself and there is not going to be any rejection, and secondly the cells are normal healthy joint cartilage cells and the arthritic defect should cover over with normal healthy cartilage, rather than the weaker fibrocartilage which may form with some of the other arthritis techniques.

But it is expensive, only done in certain centres and there is no guarantee that the cells will 'take'.