AANA Lab Course 913 - Advanced Knee Course-New Cartilage Technologies in 2019_ Ready for Prime Time_ Faculty Lecture

New Cartilage Technologies in 2019_ Ready for Prime Time_ Faculty Lecture_ Kevin Bonner, MD

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This 2019 overview by Kevin F. Bonner, M.D., discusses emerging cartilage repair technologies for knee injuries, evaluating their readiness for mainstream use.<br /><br />New treatment options include micronized extracellular cartilage matrix (BioCartilage), particulated juvenile cartilage (DeNovo NT), non-viable osteoarthritis (OA) allografts (Chondrofix), and cryopreserved osteochondral grafts (Cartiform, ProChondrix CR). Some promising products like NeoCart, NOVOCART 3D, and RECLAIM remain in clinical trial phases or are pending FDA approval.<br /><br />BioCartilage acts as a scaffold when combined with microfracture (MFX) surgery, but lacks conclusive outcome studies despite widespread use (~10,000 procedures). DeNovo NT uses juvenile cartilage to leverage its higher regenerative potential versus adult cartilage. However, high cost (~$4,300/packet) and insurance reimbursement challenges have limited its application.<br /><br />Non-viable decellularized OA allografts (Chondrofix) have shown high failure rates in early studies (up to 72% failure at 18 months). In contrast, viable cryopreserved osteochondral grafts like ProChondrix and Cartiform maintain cellular viability (70-94%) and aim for single-stage, arthroscopic-friendly repairs. Early clinical outcomes appear positive but remain limited in scale and duration.<br /><br />NeoCart (autologous cartilage implant) showed mixed results in Phase 3 trials; the company is reinitiating studies. NOVOCART 3D, a matrix-assisted autologous chondrocyte implantation combining cells with a bioabsorbable scaffold, is expected to reach market by 2024-25.<br /><br />RECLAIM innovatively uses autologous cartilage digested into chondrons combined with allogenic mesenchymal stem cells (MSCs), showing safety and feasibility in early trials.<br /><br />Cost varies widely: fresh allografts ~$10,500-12,500; MACI (matrix-induced autologous chondrocyte implantation) ~$33,000; DeNovo ~$4,300; BioCartilage around $750; and cryopreserved grafts $3,500-8,500.<br /><br />In summary, multiple advanced cartilage repair options are emerging, yet robust long-term clinical data and cost-effectiveness analyses are needed before widespread adoption.

Keywords

cartilage repair

knee injuries

BioCartilage

DeNovo NT

Chondrofix

cryopreserved osteochondral grafts

NeoCart

NOVOCART 3D

RECLAIM

autologous chondrocyte implantation