The ABICUS Trial

What is the ABICUS procedure?

ABICUS, standing for Autologous Bone Marrow Implantation of Cells, is a new technique in repairing damaged joint surfaces. It aims to grow a new joint surface within an incredibly common injury effecting damaged knees and hips known as 'chondral defects'.

These injuries happen when cartilage, a flexible tissue covering the surface of joints to reduce friction and absorb shock damage, is damaged due to either sudden twists or falls, or through contact sports among other things. One of the most common reasons is simply due to gradual wear over time. This damage does not heal and so eventually leaves the bone itself exposed. This creates friction and so the bones at the joints grind against each other which may cause pain and discomfort.

In current medical practice, the procedure most often used is a microfracture operation in which holes are made in the exposed bone to stimulate a layer of scar tissue (fibrocartillage), which works to 'plug' the effected area. Fibrocartillage is not as durable as the original cartilage it is substituting (articular cartilage), and so may degrade quickly which results in a re-exposure to the bone.

The ABICUS procedure uses a patient's own stem cells (in this case a sample of bone marrow is taken from the pelvis) to be implanted into the chrondral defect using keyhole surgery. The aim of this procedure is to form a regenerated version of the joint surface, providing a more substantial cartilage replacement to the fibrocartillage collected in a microfracture operation. If you undergo the ABICUS procedure, the only noticeable addition would be a wound dressing over the area in which bone marrow cells are taken.

Amir Qureshi is one of the three surgeons at UHS involved in the trial.

Nature of the trial

The trial is a randomised control which will be given to patients with chrondral defects, in which half of the patients will be given microfracture operations and the other half will be given ABICUS Trial keyhole operations. This is to ensure a balanced test. Taking part in this study is entirely optional however.

Both procedures are minimally invasive and there is no bias as to which test a patient may be given as it is randomised by a computer. The aim of the study is to compare the two procedures for the treatment of cartilage defects in the knee to see which one provides the better pain and movement performance- the idea being that the new ABICUS technique will fill the defect with the patient's own cells instead of scarring existing tissue to cover it. This could lead to a better outcome with the high potential of reducing the chance of developing arthritis in the knee after the operation. The trial will take place for 12 months and has been reviewed and approved by a research ethics committee: South Central - Hampshire B.

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