New Cartilage Regeneration Procedure? Really?

It’s finally here–a cartilage regeneration/regrowth product from ZimmerimagesCA76UD4P.

We’ve been waiting for this a very long time.

Unfortunately, it costs about as much as a 1999 Ford Mustang GT or a safari in Tanzania for two, but the results are quite impressive.

A couple of weeks I was invited to a demonstration and product presentation here in Toronto hosted by Zimmer Canada. Head scientists and surgeons who have already trialed the product were on hand to answer questions and share their experience.

What is Cartilage?untitled

As a reminder, cartilage is the tissue that covers the bone surfaces within your knee joint– it absorbs shock and protects the ends of the bones from each other. It’s like the shiny ends of a chicken drumstick (which by the way is a chicken knee, in case you didn’t know).

When the knee cartilage becomes damaged, the joint begins to wear out and we develop osteoarthritis–or “wear and tear” arthritis (inflammation, pain, reduced weight-bearing tolerance and pain).

Unfortunately, once you are fully grown, cartilage has minimal regrowth potential. The individual cartilage cells are few and far between, there is little renewal of these cells and even less turnover.

So How Do We Renew Our Own Knee Cartilage?

Forget all the hype about glucosamine and shark cartilage–there is no scientific proof that lost cartilage regrows with these supplements. Over the years we have tried many different types of cartilage growth techniques–from implanting pouches of cells, to injecting cells, to transplanting cartilage from one area of the knee to another. Some of these techniques work for very small areas, but most were either too costly ($30,000 in some cases) or simply did not offer good results.

Zimmer says “Replacing lost knee cartilage with tissue grafts may help restore normal knee function and may delay or even eliminate the need for a knee replacement.”

What Are Cartilage Tissue Grafts?  -denovo-hero2

The tissue graft procedure is a relatively straightforward cartilage repair surgery. Tissue overgrowth or thickening at the repair site may necessitate a secondary arthroscopy procedure to trim the excess tissue. Some people may exhibit an allergic response to the graft. This may include short-term discomfort and swelling, and potentially an overall rejection of the graft.

Will a tissue graft to repair my lost knee cartilage limit my future options?

No. Tissue grafts will not interfere with future treatment options, such as surgery or knee replacement, should they become necessary.

DeNovo NT Natural Tissue Grafts are Zimmer’s new product now available in Canada. They are donor collections of small pieces of juvenile joint cartilage that are implanted into the affected areas of cartilage loss by a surgeon.graft

The graft contains living cartilage cells that have the potential to grow and repair areas of lost cartilage by filling defects caused by trauma or natural wear and tear.

Is using donor tissue for knee cartilage grafts safe?

According to Zummer, DeNovo NT Graft donors are screened and tested. Each lot of donated tissue is processed in a sterile environment and individually tested prior to release to reduce the risk of bacterial and fungal contamination. There is a very small risk of rejection compared to any other natural tissue such as organs.

DeNovo NT Graft has been used safely in over 1000 human clinical cases with very good results.

For more information, visit the Zimmer website here:


New Drug to Renew Cartilage in Osteoarthritis Patients Promising

Rush University Medical Center is conducting the nation’s first clinical study of an innovative stem cell drug, Cartistem, to repair knee cartilage damaged by aging, trauma or degenerative diseases such as osteoarthritis. According to Science Daily, Cartisem is manufactured from the controversial umbilical cord stem cells. It is less of an ethical dilemma than other sources of stem cells as newborn infants no longer need their umbilical cords and they tend to be disposed of by pathologists after a brief inspection to ensure the newborn had a healthy placenta and cord.

The stem calls, which are the building block cells of most important organs and structures in the body, are harvested and transformed into cartilage cells and injected into the area of lost cartilage during a surgical procedure.

Science Today interviewed the Chief Investigator, Dr. Brian Cole, who says “Finding a biological solution for cartilage regeneration in orthopedics is one of the fastest growing areas of research and development in our specialty–Rush is spearheading this field of research with the ultimate goal of safely improving outcomes and sparing patients from having more complicated surgery at a relatively young age.”knee_cart_surg_intro01

According to Cole, this treatment is designed for patients with small areas of lost cartilage or exposed bone in joint such as the knee, not for patients with diffuse generalilzed osteoarthritic changes.

So an osteochondral injury–where a “chunk” of cartilage has been knocked off the bone surface by trauma; or a smaller area of worn-away cartilage are best treated with this new compound.

Although not yet available outside of clinical trials, and certainly not on the market in Canada, Cartistem is a promising idea for a disease of which there is no known cure — osteoarthritis.