Stem cell trial could help Australians with worn-out knees

Hundreds of Australians are being recruited in a pivotal trial to determine whether stem cells should be recommended for patients with worn-out knees.

Experts say high-quality evidence is needed before the procedure can be considered as a credible option for osteoarthritis patients.

"There's a lot of talk, there's a lot of enthusiasm, but there's no good rigorous evidence to suggest they are effective in this context," the trial's lead investigator, Professor David Hunter at the University of Sydney's Institute of Bone and Joint Research, said.

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The latest trial is recruiting 440 patients and will test a stem cell therapy against a control group that will receive saline injections.

It will be blinded, so volunteer patients won't know which injection they will receive.

The study is being funded by the National Health and Medical Research Council and will be one of the world's largest clinical trials to use stem cells for osteoarthritis.

Trial participants will receive an off-the-shelf product manufactured by an Australian company called Cynata Therapeutics.

Most experimental interventions use stem cells extracted from a patient's own fat tissue.

The new trial therapy uses stem cells from the blood of a single healthy donor, which is then expanded and reproduced to commercial scale.

"Every patient (in the treatment group) is going to receive the same thing, taking one of the uncertainties out of the picture," Professor Megan Munsie, deputy director of Melbourne University's Centre for Stem Cell Systems, said.

Participants will receive ultrasound-guided injections in their joints three times over the course of a year.

The trial will mainly focus on whether the treatment can relieve pain and make a structural difference by slowing down cartilage loss or aid repair.

The duration of any benefits will also be assessed which is why the trial will run for two years at centres in Sydney and Hobart.

In the meantime, experts say patients with knee osteoarthritis should devote more time to strategies that have shown to work.

"We have very strong evidence to support exercise and weight loss but it's underutilised and not well supported under our health system," Associate Professor Dawn Aitken, osteoarthritis specialist at Hobart's Menzies Institute, said.

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Tom Buttel, 61, has struggled with knee osteoarthritis for most of his life and believes the trial will give patients like him more clarity.

"It's quite an expensive procedure so the science needs to be behind it," he said.

"It either works or it doesn't."

He says education, weight loss and exercise have helped him manage his symptoms and relieve the pain.

Details on the trial can be found here.