Celebration to mark end of major clinical trial

A major clinical trial which has helped to transform the lives of people suffering with damage to their knee joint or cartilage is coming to an end.

It has been running at The Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry – in partnership with Keele University and supported by the Orthopaedic Institute Charity, Versus Arthritis and the Medical Research Council.

The hospital has led the way in pioneering a specialised treatment called Autologous Chondrocyte Implantation (ACI), in which patients have their own cartilage cells (called chondrocytes) taken out of their knee, grown in a laboratory and then put back into the knee in a second procedure to repair the damaged cartilage and slow or stop the degenerative process. Clinical ACI studies began in the late 1990s and were finally given approval by the National Institute for Health and Care Excellence (NICE) for use on the NHS in 2017.

But by then a new trial had started called ASCOT (Autologous Stem cells, Chondrocytes Or the Two), in which stem cells from the patient’s bone marrow were also used to repair damage. The ASCOT trial aimed to determine if there are differences in patient outcome when using stem cells from bone marrow, either alone or in combination with ACI.

Today, clinicians and a cohort of around 30 patients attended a celebratory event to mark the end of the trial and consider next steps.

Dr Karina Wright, a Research Scientist from Keele University but based at RJAH, is a key member of the team overseeing the ASCOT trial. She said: “The pain and disability from end-stage osteoarthritis (OA) is well known, as too is the success of knee and hip replacements. 

“However, most patients receiving joint replacements will suffer an injury causing damage to their cartilage or joint many years or decades before, starting a degenerative process that forces them to live in great pain. As a result, patients are unable to do their job or things they wish until they are ‘old enough’ to have a new knee or hip.

“ACI and the work we have done on the ASCOT Trial have been giving these patients new hope. We’ve had more than 100 patients on the ASCOT Trial, and seen impressive results.

“We do need to keep monitoring these patients to see the long-term benefits of the treatment before we can give definitive recommendations, but the active part of the trial has come to an end. We are hugely grateful to the Orthopaedic Institute, Versus Arthritis and the Medical Research Council for the ongoing support they have given us over the years, which has made it possible for us to get to where we are today.”

One of the patients attending the event at the hospital today was Lauren McMinn, a professional tennis player from Shrewsbury who feared her career was over when in 2017, at the age of just 23, she suffered a painful cartilage injury. Lauren’s career had been on an upward curve until this point, and she had even been training with legendary Belgian Grand Slam champion Kim Clijsters.

Lauren, now 30, endured two years of pain after an original arthroscopy operation to ‘clean out’ her knee failed to deliver the desired results.

But she went on to undergo cell therapy on the ASCOT Trial and has since recovered to the point that earlier this year she was able to take part in her first two international events since the injury.

“As a sports person you are really identified by your career,” said Lauren. “I viewed myself as an athlete and I started to wonder if that is going to come to an end. I didn’t really know how to deal with that.

“Since having cell therapy, I have managed to go back to playing tournaments. I played a couple earlier this year at an international level – I didn’t win, but the fact that I walked off court in one piece was already a win for me.

“I’m hoping that over the next few months I can play a few more. I’m just going to keep going and see how far I can get.”

Debra Alexander, Fundraiser for the Orthopaedic Institute Charity said: “We are incredibly proud to have supported The Robert Jones and Agnes Hunt Orthopaedic Hospital for over 50 years.

“Based here at the hospital, every penny we raise through donations and grants, funds teaching and research in the specialist centres and departments. 

“To know that we have helped fund both the OSCELL Cell Manufacturing Facility to produce the chondrocytes and the ASCOT Clinical Trial, reiterates just how important our work is. We need to continue raising funds to help many more patients in the future.

“We are extremely grateful for the support received year on year which enables us to continue with these vital services.  If you can help us raise funds for further research into improved methods of care for patients suffering from arthritis, osteoarthritis and rheumatoid arthritis please, contact us on 01691 404561, or email enquiries@orthopaedic-institute.org.”