What is Articular Cartilage?

Articular cartilage is a highly specialized, uniquely designed biomaterial forming smooth gliding surface for diarthrodial joints.

Anatomy of Cartilage

Cartilage is tough, elastic, durable connective tissue found in most of the joints such as:

  • Knee
  • Ankle
  • Shoulder
  • Hip
  • Elbow

Characteristics of Cartilage

  • Avascular(no blood supply)
  • A neural(no nerve supply)
  • A lymphatic matrix(no lymphatic supply)
  • Immunologically naïve(natural and unaffected)

Types of Cartilage

  • Hyaline - most common, found in the ribs, nose, larynx, trachea. Is a precursor of bone.
  • Elastic - is found in the external ear, epiglottis and larynx.
  • Fibro - is found in invertebral discs, joint capsules, ligaments.

Functions of Cartilage

  • Helps support our weight, when we run, walk, bend and stretch
  • Allows smooth movement
  • Acts as shock absorber
  • Reduces friction between bones.

What is an Articular Cartilage Injury?

Cartilage has a poor blood supply unlike other tissue such as skin. Any injury to cartilage leads to underlying bones to rub against one another causing pain and inflammation.

Common symptoms of Cartilage Injury

  • Articular cartilage has a limited capacity for intrinsic healing and repair.
  • Injury begins an inexorable cascade of events both chemical and then mechanical leading toward degenerative joint disease.
  • May progress to end stage arthritis.
  • If cartilage damage is left untreated, it will progress to Osteoarthritis (OA) and eventually, Joint Replacement.

About Autologous Chondrocyte Implantation (ACI)

Cell therapies are in use for cartilage repair .ACI involves harvesting a biopsy of the patients cartilage, isolating & expanding the cells and re-implanting them into the defect site

History

  • Cartilage Cell Therapy was first invented in 1987 at University of Gothenburg, Sweden by Dr. Lars Peterson & Dr. Matts Brittberg.Now, recognized First Choice of treatment for full-thickness chondral defect.
  • More than 40,000 patients across the world have undergone treatment with Cartilage Cell Therapy in last 20 years for knee, ankle, hip & shoulder joints.
  • Results are supported in peer reviewed scientific publications by clinicians proving excellent results with reduction in pain and increase in patient activity levels.

Goal of Treatment

  • Restore smooth articular cartilage surface
  • Relieve patient symptoms and improve function
  • Match biomechanical/biochemical properties of normal hyaline cartilage
  • Prevent or slow progression of focal chondral injury to end- stage arthritis

ICRS Grading for Cartilage Injuries

Unmet Clinical need of Orthobiologic treatment

Case Reports

Our Process

Step 1

Cartilage Tissue Biopsy

Step 2

Cartilage Cell Implantation

  • The cultured cells (48 million chondrocytes) are simply implanted onto the damaged area of the knee.
  • Immediate mobilization of the knee is encouraged which allows the cells to initiate its biological process of forming new cartilage tissue.
  • Through constantly guided physiotherapy including the muscle strengthening and load bearing capacity exercises, the new cartilage tissue formed becomes mechanically very robust allowing all activities including professional sports by 6months

Implantation Procedure:

  • Defect debridement
  • Curette up to sub-chondral bone
  • Edges should be sharp and remove all fibrous tissue from defect area
  • Drill hole 2-3 mm deep with 2 mm drill bit
  • 3 to 4 holes in per sq. cm
    • Pour saline on defect area to confirm gravity eliminated position.
  • Filling of defect area with final product
    • Slowly inject the gel onto the defect.
    • First fill the holes.
    • Then evenly distribute the cells by moving the injection central to peripheral and peripheral to central.

Step 1

Step 2

Step 3

Billing and Insurance

  • Government purchases can be made through direct purchase option on www.gem.gov.in
  • All Regrow bills include transport and delivery kit charges.
  • Regrow invoice is submitted at time of biopsy to private institutions.
  • Regrow products are covered by all private and Govt.insurance schemes.

To place the order or to know more about the product, please call :

Dr. Charul Bhanji
Technical Director
 9821186618

Mr. Amos Chopade
Medical Officer
 9619835838

Medical Education

  • Publications
  • Presentations
  • Clinical Trial Summary

Please refer to our academic library for peer reviewed International Publications on ACI

Sato M, Ochi M, Uchio Y, Agung M, Baba H. Transplantation of tissue-engineered cartilage for excessive osteochondritis dissecans of the elbow. Journal of shoulder and elbow surgery. 2004 Mar 1;13(2):221-5.
Minas T, Gomoll AH, Solhpour S, Rosenberger R, Probst C, Bryant T. Autologous chondrocyte implantation for joint preservation in patients with early osteoarthritis. Clinical Orthopaedics and Related Research®. 2010 Jan 1;468(1):147-57
Buchmann S, Salzmann GM, Glanzmann MC, Wörtler K, Vogt S, Imhoff AB. Early clinical and structural results after autologous chondrocyte transplantation at the glenohumeral joint. Journal of shoulder and elbow surgery. 2012 Sep 1;21(9):1213-21
Von Keudell A, Han R, Bryant T, Minas T. Autologous chondrocyte implantation to isolated patella cartilage defects: two-to 15-year follow-up. Cartilage. 2017 Apr;8(2):146-54
Lee KT, Kim JS, Young KW, Lee YK, Park YU, Kim YH, Cho HK. The use of fibrin matrix-mixed gel-type autologous chondrocyte implantation in the treatment for osteochondral lesions of the talus. Knee Surgery, Sports Traumatology, Arthroscopy. 2013 Jun 1;21(6):1251-60
Goyal D., Modi V. Gel based Autologous Chondrocyte Implantation: The Surgical Technique. Asian Journal of Arthroscopy 2019 Jan-Apr; 4(1): 27-33
Mithoefer K, Peterson L, Saris DB, Mandelbaum BR. Evolution and current role of autologous chondrocyte implantation for treatment of articular cartilage defects in the football (soccer) player. Cartilage. 2012 Jan;3(1_suppl):31S-6S
Kim SJ, Chang CH, Suh DS, Ha HK, Suhl KH. Autologous chondrocyte implantation for rheumatoid arthritis of the knee: a case report. Journal of medical case reports. 2009 Dec;3(1):6619
Peterson L, Vasiliadis HS, Brittberg M, Lindahl A. Autologous chondrocyte implantation: a long-term follow-up. The American journal of sports medicine. 2010 Jun;38(6):1117-24
Brittberg M. Autologous Chondrocyte Implantation for Cartilage repair: Still experimental? ASPETAR Sports Medicine Journal. 40-47.
Dalal, S., Shah, N., Pardiwala, D., Rajan, D., Sanghavi, S. and Bhanji, C., Gel-Based Autologous Chondrocyte Implantation (GACI) in the Knee: Multicentric Short Term Study. World Academy of Science, Engineering and Technology, International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering, 9(12), pp.883-886.
Saris D, Price A, Widuchowski W, Bertrand-Marchand M, Caron J, Drogset JO, Emans P, Podskubka A, Tsuchida A, Kili S, Levine D. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: two-year follow-up of a prospective randomized trial. The American journal of sports medicine. 2014 Jun;42(6):1384-94
Pardiwala D, Soni S, Rao N, Mandapalli P.Osteochondral Lesions of the Talar Dome. Asian Journal of Arthroscopy 2018May-Aug; 3(2): 13-19
Franceschi F, Longo UG, Ruzzini L, Marinozzi A, Maffulli N, Denaro V. Simultaneous arthroscopic implantation of autologous chondrocytes and high tibial osteotomy for tibial chondral defects in the varus knee. The Knee. 2008 Aug 1;15(4):309-13
Chondrocyte SG, Microfracture IV. Articular Cartilage Treatment in High-Level Male Soccer Players. The American Journal of Sports Medicine. 2011;39(12).
Von Keudell A, Gomoll AH, Bryant T, Minas T. Spontaneous osteonecrosis of the knee treated with autologous chondrocyte implantation, autologous bone-grafting, and osteotomy: a report of two cases with follow-up of seven and nine years. JBJS. 2011 Dec 21;93(24):e149

Coming Soon

TOP