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Gel-Repairer is a biomaterial composed of Polydeoxyribonucleotides (Pdrn), Heat Shock Proteins (Hsps) and a thickening substance. It works as a local mesenchymal stem cells (MSCs) stimulator, finally generating connective tissue renewal. Our research is within the field of regenerative medicine and has historically built its foundation from the studies carried out on non-vital amnion and placental membranes. Our end point is the activation and stimulation of the local mesenchymal stem cells (MSCs) for the structural recovery of the joint involved in the degenerative process. Since 2003, we have been applying the Gel Repairer over more than 1200 patients, most of them elderly, affected by Degenerative Joint Disease (DJD). After 10 years of clinical experience, the results are really impressive, including the absence of toxicity, adverse reactions or side effects. Our clinical findings allowed the presentation of a clinical preliminary study performed on a large group of patients from 2003 to 2009 and recently published [1]. The following article is aimed at looking into the mechanism of action of the Joint Self-Repair procedure; furthermore some new technical opportunities are presented on tissue engineering advances in this fast evolving sector.

This study presents a method for treating and structurally improving articulations affected by degenerative joint disease (DJD). The focus of this analysis is on two groups of patients: the first comprised patients over eighty years old, and the second comprised patients aged 45 to 55 years. The first group was a high surgical risk and both had been nonresponders to current conservative therapies. Scholars like Davis, Filatov, and Cerletti have been studying and using the regenerative properties of placenta, amnios and other nonvital tissues since the early 1900s. These pioneering studies have opened a new track for tissue renewal. More recently, the new biological knowledge about extracellular nucleic acids, growth factors (GF) (as by-products of trauma response), and heat shock proteins (Hsp) has helped research even further. Building on those experiences, we have developed a regenerative gel obtained with distressed, processed blood, polydeoxyribonucleotides (Pdrn), and a thickening substance. The objective was to stimulate the local innate stem cells with our gel in order induce tissue repair. From 2003 until 2009, we treated 948 patients. As mentioned, the first group comprided of 86 ultra-octogenarian patients with severe osteoarthritis (OA) of the hip and/or knee, and the second group comprised of 90 younger patients (around 50 years old) affected by the same disease. Treated patients have been clinically and radiologically evaluated with a follow-up of 6 to 48 months. Results show a statistically significant improvement in terms of pain and joint mobility, sometimes coupled with clear improvement in radiological imaging. Follow-up shows encouraging data in terms of clinical stability over time. During the study, we encountered virtually no side effects, adverse reactions, or toxicity. Currently the pharmacological treatment of DJD is palliative, though toxicity and side effects of the drugs remain problematic. Patients who can be operated on conclude their trial with a prosthesis followed by a long rehabilitation period. This study presents a new methodological approach to the treatment of DJD based on tissue regeneration and restoration resulting in a positive clinical resolution.