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By Pallab GhoshScience correspondent, BBC News Writing in the The Lancet, US researchers say they have regrown the forelimb thigh joint of rabbits using their own stem cells. It was the first time an entire joint surface had been regenerated with the return of functions, they said. The research could benefit patients with damaged hips, shoulders or knees. The team removed the limbs from 10 rabbits and replaced them with an artificial limb-shaped skeleton. This was soaked with chemicals which attract bone and cartilage stem cells. Four weeks later the rabbits had regrown their joints and were able to move normally. "This is the first time an entire joint surface was regenerated with return of functions including weight bearing and locomotion," said Professor Jeremy Mao of Columbia University Medical Center, New York. "Regeneration of cartilage and bone both from the host's own stem cells, rather than taking stem cells out of the body, may ultimately lead to clinical applications. In patients who need the knee, shoulder, hip or finger joints regenerated, the rabbit model provides a proof of principle," he said. Researchers have artificially grown a range of tissue on scaffolding using stem cells for many years, but these have been grown in laboratories. The lab grown tissue has been quite small and has had no veins or arteries to supply them with blood. More recently, however, several groups of researchers have successfully grown tissue inside animals, where blood vessels naturally form as the tissue grows. The US group is the latest to have shown that this is a promising technique - and is the first to have grown a large amount of good quality bone and cartilage into successful working joints. 'Too old' According to Professor Patrick Warnke, a stem cell researcher and plastic surgeon at Bond University in Australia, there is technically no reason why trials should not begin on human patients, for example as an alternative to hip replacements. But he said there were ethical issues to be considered before beginning clinical trials. "A hip replacement would definitely cure any potential recruit to any clinical trial. On the other hand you have an experimental treatment that may turn out to be a better option - but may not work at all," he said. If human trials were to be approved they would not be suitable for very old patients, according to Professor Warnke. "It would take months of movement, physiotherapy and bed rest for the joint to grow which would be much too long for older people. They would be better off with a normal hip replacement when they can walk out of the hospital after the procedure." Professor Molly Stevens of Imperial College London said: "Growing large areas of tissue is a massively important clinical goal. "This is the latest study to have shown that there are stem cells in the body that can be harnessed to grow bone and tissue if they are given the right sort of signals."
Hip hope from stem cell technique

Nick TriggleHealth correspondent The introduction of a £75,000 cap - if introduced - will arguably be the first time the system has been overhauled since it was created along with the NHS after the Second World War. Understandably, the plans have been widely welcomed with campaigners willing to give the government credit for doing this at a time when the financial situation makes it harder to do than it has been for a long-time. But despite the breakthrough it is not quite the panacea it may seem on first glance. Many people will still not get any help from the state The government is effectively saying it wants to see a partnership between the state and individual. It is promising to pick up the really high costs, while leaving the individual to cover the cost of the average care package. But less than a fifth of people face costs in excess of £75,000, meaning the majority of people will still have to pay all of their bill. About a quarter of people do not develop any care needs - or very little, while for another quarter the costs of care are below £20,000. However, for a third of people the bill is between £20,000 and £75,000 - they will not get any help unless they fall below the means-testing threshold as the least well-off do not have to pay the full costs of care. But of course many will say that is better than the current situation where people can face unlimited costs - and the hope is that the insurance industry will develop products that will cover the costs people face. You won't be able to shop around for the best services The cap only includes services that are available at the normal council cost. If you want to move into a luxury care home or pay to get the best help you will have to cover that extra cost yourself. Any spending above what the local council would have paid for would not count towards the cap, leaving the individual to top up their package. It means relying on the current quality of services available if you want to stay within that £75,000 sum. Unfortunately the system, according to the Local Government Association, is drastically under-funded, which is hampering the ability to meet the needs of the elderly. The government spends less than £10bn a year on social care for the elderly - a tenth of what is spent on the NHS and a quarter of the defence budget. The criteria for being entitled to social care help will be extremely high Just because you develop a care need, it does not mean you will fall within the system. Only those with needs classed as severe or substantial will be entitled to help - that basically means you need round-the-clock help. Any spending before you reach that level of need will not count towards the £75,000 cap. It will mean many will still have to struggle to get by on their own until their situation worsens. That is no different to how it is now, although a decade ago many councils were able to offer help to those with low or moderate needs. The social care system, in a nutshell, will only be there for the most frail. Care homes will still be expensive places A cap of £75,000 is a substantial sum of money, but on top of that people face paying so-called accommodation costs. This is to cover the cost of things such as food, bills and renting the room. Of course, these are the kind of costs elderly people face if they are in their own home - and that is one of the reasons why there is a state pension. But with annual "accommodation" bills often hitting the £10,000 mark, a care home place will be a more expensive arrangement than the status quo for most.
What the cap on care costs doesn't do

Volunteers have already raised £89,000 by braving rain and cold temperatures inside the grounds of Cardiff Castle. They were joined by celebrities including Ruth Jones, Charlotte Church and Richard Parks, as well as musical acts on stage. The event, hosted by charity Llamau, was part of a global campaign to end homelessness. Ceris Jones has raised money but said raising awareness of the issue was just as important. "It's not just about charities helping those on the streets, there are lots who are living with friends, sofa-surfing or living in refuges who need help and support," he said. "It's a real problem in Wales and it shouldn't be happening on our streets." The global event in 50 cities is expected to attract about 50,000 people. Half of the money raised is directly helping Llamau's work in Wales. Last year 7,5000 young people in Wales asked their local authority for help with homelessness, the charity said. Jenna Lewis, Llamau director, said: "The problem has increased massively in recent years, both on our streets and the hidden homelessness of people living in places that aren't safe. "If we can help people sooner then we can help Wales become one of the first countries in the world to end homelessness."

Hundreds sleep rough in Cardiff Castle to highlight homelessness

