Cartilage defect treatment

Amedrix develops implants for the regeneration of articular cartilage defects. The articular cartilage is a viscoelastic tissue and is located in regions with a high compressive load e.g. articulated joints.
Cartilage lesions can occur through direct or indirect injuries or damages. These lead to smaller or larger defect sizes which can heal spontaneously during growth phases. After these phases, the capability to repair the articular cartilage is lost. No autoregeneration takes place.

Cartilage lesions can occur at any point in life. There are various reasons for such lesions such as an attendant trauma with injuries to the cruciate ligament or knee joint luxations. In addition physical activities, daily movement, biomechanical stress and overload of the cartilage can cause an ablation of cartilage tissue. These kinds of cartilage lesions are not always accompanied by pain.

Local cartilage defects without visible causes often occur in the knees, ankles and shoulder joints. Osteochondrosis dissecans (OD) is a disease of the bone below the cartilage which can lead to cartilage damages. Bone areas can collapse which leads to a displacement of cartilage pieces in the course of the OD. Without an adequate therapy the risk of early arthrosis increases dramatically. If a cartilage piece separates itself completely it can lead to acute pain and limited mobility.

In the beginning chronic cartilage defects which emerge from a long period of abrasion cause pain during physical load companied by swelling of the effected area. Progressively the pain increases especially when resting and at night. After a warm-up phase, typically pain decreases though after sufficient physical load it increases. Moreover effusions occur frequently – particularly in the knee joint.

Every year 6 million patients suffer from articular cartilage defects in the knee joint. In Germany 10 thousand patients receive cartilage treatment. Below are possible reasons for the increase of arthropathies every year:
  • increased life expectancy
  • increase of physical activities at every age
  • increase of physical activities with a high potential of risk
  • Mobility to an advanced age
  • increase in body weight
  • decreased implantation of artificial joints  in patients younger than 60 years

Current possible treatment strategies for articular cartilage defects:

  • Joint lavage and the smoothing of cartilage usually does not lead to regeneration
  • bone marrow stimulating therapies usually lead to fibrous cartilage with limited function and constancy
  • Autologous osteo-chondral transplantation (OATS) is connected with a high extraction morbidity and limited for small defects
  • Autologous chondrocytes tranplantation (ACT and MACT) requires 2 surgical procedures for attaining a biopsy. Furthermore it is usually a complex and expensive technique
  • artificial joint replacement has a limited lifetime and is only suitable for patients older than 60 years