HOAST Trial

Background

HOAST is a world-first study into whether stem cells can replace damaged tissue in the hip joint, delaying the need for a hip replacement in younger people.

In osteoarthritis (OA) this joint cartilage becomes damaged and worn, causing the joints and the tissues around the joints to become inflamed. The cartilage is unable to heal itself, which can result in pain and stiffness of the joint.

In recent years a new keyhole surgery technique has been developed that may stop OA worsening, called microfracture. This involves drilling tiny holes into the area of cartilage damage to promote bleeding and the creation of scar tissue to form a new surface for the joint.

This study investigates whether microfracture can be improved on by using stem cells, the body's 'master cells' that can renew themselves and form many other different types of cells, in this case cartilage. Stem cells are harvested from the patients bone marrow during the operation and applied to areas of cartilage damage. It is hoped the stem cell technique will replace the damaged cartilage with new cartilage as opposed to scar tissue. This may provide a long term solution and promote faster healing, enabling patients to return to an active life sooner.

Suitable NHS patients will be asked by their consultant if they wish to take part in the trial, to take place at Oxford's Nuffield Orthopaedic Centre (NOC).

The trial will start with an initial pilot phase of 40 patients. Half will be randomly allocated to standard treatment and the other to the treatment using stem cells, so the two can be compared to see which is the most effective.

Those who get standard treatment will also have stem cells extracted for future assessment in the lab. All will complete questionnaires and undergo scans and follow-up care. Patients will not know which treatment they have received, so as to not influence their questionnaire answers.