Living Knee Replacement to Revolutionize Osteoarthritis Treatment

Osteoarthritis is the most prevalent type of arthritis, characterized by the progressive deterioration of cartilage, or the protective tissue covering the bone ends, resulting in pain, stiffness, and impaired movement. This condition ranks as the third leading cause of disability and imposes an economic impact exceeding USD 136 billion annually. Its incidence is notably higher among women, older adults, certain racial and ethnic groups, and individuals from lower socioeconomic backgrounds, with knee osteoarthritis incidents rising due to the aging population, more frequent joint injuries, and notably, an increase in obesity.

Currently, the standard clinical remedy for severely damaged knee joints due to osteoarthritis or traumatic injuries involves total joint replacement using prosthetics composed of metal and plastic. Despite the widespread success of knee replacements, these traditional materials come with significant downsides, including the potential for infection, loosening, mechanical failure, stiffness, unnatural knee movement, instability, and continuous pain. Moreover, these knee replacements typically last 15 to 20 years, requiring subsequent replacements in younger patients due to wear and tear of the plastic components or loosening of the implant.

Image: The living replacement knee will be tested in clinical trials within five years (Photo courtesy of ARPA-H)

A team of biomedical engineers from Columbia University (New York, NY, USA) is collaborating with orthopedic surgeons to build a living replacement knee from biomaterials and human stem cells, including a patient’s own cells. The development of NOVAJoint, the revolutionary biocompatible, low-cost, patient-specific knee joint replacement, builds upon more than two decades of collaborative musculoskeletal research at Columbia in engineering and medicine, and could provide a transformative solution for millions of people globally who suffer from osteoarthritis. NOVAJoint aims to address the urgent, unmet clinical need for a permanent solution for patients with advanced osteoarthritis where a conventional knee replacement is required.

The project’s goal is to engineer a knee replacement composed of regenerated living cartilage and bone that seamlessly integrates with the body's native bone, restoring pain-free joint function. Taking into account the fact that cells are required to regenerate and maintain this living implant, two versions of NOVAJoint will be created: one utilizing the patient's cells and another employing donor cells. NOVAJoint is expected to significantly prolong the lifespan of the implant, minimize complications, and serve as a definitive treatment for knee osteoarthritis. The project timeline is ambitious, with plans to develop the initial prototypes within the first two years, followed by preclinical and clinical trials in the subsequent three years, including a Phase 1 safety clinical trial in the final year.

“This is a big challenge, but by creating a large and experienced team that works well together and can be focused on one goal, we expect to succeed,” said Nadeen O. Chahine, Associate Professor of Biomedical Engineering at Columbia University and a leader in orthopedic research. “NOVAJoint will mark a major milestone in the field of regenerative medicine and orthopedic surgery, and has the potential to revolutionize musculoskeletal treatments of the many joints that degenerate with age or injury.”

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