NeoCart Autologous Cartilage Tissue Implant For Cartilage Regrowth And Replacement

Me: I have recently found out about this product being sold called NeoCart, an autologous cartilage tissue implant, which seems to be using the technology of cartilage regrowth for eventual surgical implantation to heal fractures. What is nice about this product is that one can just buy it. To make the NeoCart product it is “produced by seeding a type-I collagen matrix scaffold with autogenous chondrocytes and bioreactor treatment“. The implications of this product and technology is that we can see that there are already places where we can buy these cartilage implants or get their services. What might be good is if we can figure out what type of growth factors were used in the bioreactor treatment along with the implanted chondrocytes. This might give us a bigger clue on how to cause induced or injected chondrocytes into bones to increase and create a cartilage layer. 

From Histogenics website HERE

Histogenics grows the NeoCart® implant ex vivo (outside the body) from the patient’s own cartilage cells in a patented, high-pressure tissue engineering processor. This processor mimics the natural conditions experienced in the knee while walking, producing more natural neocartilage than other techniques.

Phase I trials showed improvement in function and relief of pain, with 87.5 percent of subjects with good fill at 12 months, versus 50 percent of subjects with good fill who had undergone microfracture. The NeoCart Phase II trial is complete, with 6, 12 and 24-month data trends superior to the control arm microfracture.

Advantages
NeoCart implant promises an advanced solution for joint repair to help restore a patient’s active lifestyle.

  • Starts with a patient’s own cartilage cells from a simple biopsy
  • Incorporates patented 3D matrix to protect cells and encourage growth and development of cartilage tissue
  • Results in optimally produced tissue containing both multipying cells and substantial amount of true cartilage tissue
  • Is easy to handle and implant
  • Can treat large cartilage defects
  • Uses proprietary bioadhesive for strength and biocompatibility – no suturing
  • Integrates with surrounding native cartilage

Treatment
NeoCart treatment has three phases.

Cell collection.The process begins during a short, simple arthroscopic examination when an orthopedic surgeon takes a cartilage biopsy from a non-weight bearing area of the joint. The tissue biopsy is sent to the Histogenics manufacturing facility for culturing into the implant.

Tissue production. The cartilage cells, or chondrocytes, are isolated from the cartilage and multiplied using standard tissue culture techniques. The cells are harvested, seeded into a unique 3-dimensional collagen scaffold, and cultured under exacting conditions of high pressure, oxygen concentration and perfusion.

Implant. After a few weeks, a discrete three-dimensional piece of the patient’s own neocartilage, having characteristics of maturing native articular cartilage, is sent to the physician and implanted into the defect in a simple procedure that usually takes less than an hour. Within months, the matrix remodels, the cells mature, and the cartilage integrates with the host tissue.


From PubMed study link HERE

J Bone Joint Surg Am. 2012 Jun 6;94(11):979-89. doi: 10.2106/JBJS.K.00533.

NeoCart, an autologous cartilage tissue implant, compared with microfracture for treatment of distal femoral cartilage lesions: an FDA phase-II prospective, randomized clinical trial after two years.

Crawford DC, DeBerardino TM, Williams RJ 3rd.

Source

Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, Mail Code OP31, Portland, OR 97239, USA. crawfden@ohsu.edu

Abstract

BACKGROUND:

Despite introduction of autologous chondrocyte therapy for repair of hyaline articular cartilage injury in 1994, microfracture remains a primary standard of care. NeoCart, an autologous cartilage tissue implant, was compared with microfracture in a multisite prospective, randomized trial of a tissue-engineered bioimplant for treating articular cartilage injuries in the knee.

METHODS:

Thirty patients were randomized at a ratio of two to one (two were treated with an autologous cartilage tissue implant [NeoCart] for each patient treated with microfracture) at the time of arthroscopic confirmation of an International Cartilage Repair Society (ICRS) grade-III lesion(s). Microfracture or cartilage biopsy was performed. NeoCart, produced by seeding a type-I collagen matrix scaffold with autogenous chondrocytes and bioreactor treatment, was implanted six weeks following arthroscopic cartilage biopsy. Standard evaluations were performed with validated clinical outcomes measures.

RESULTS:

Three, six, twelve, and twenty-four-month data are reported. The mean duration of follow-up (and standard deviation) was 26 ± 2 months. There were twenty-one patients in the NeoCart group and nine in the microfracture group. The mean age (40 ± 9 years), body mass index (BMI) (28 ± 4 kg/m2), duration between the first symptoms and treatment (3 ± 5 years), and lesion size (287 ± 138 mm2 in the NeoCart group and 252 ± 135 mm2 in the microfracture group) were similar between the groups. Adverse event rates per procedure did not differ between the treatment arms. The scores on the Short Form-36 (SF-36), Knee Injury and Osteoarthritis Outcome Score (KOOS) activities of daily living (ADL) scale, and International Knee Documentation Committee (IKDC) form improved from baseline (p < 0.05) to two years postoperatively in both treatment groups. In the NeoCart group, improvement, compared with baseline, was significant (p < 0.05) for all measures at six, twelve, and twenty-four months. Improvement in the NeoCart group was significantly greater (p < 0.05) than that in the microfracture group for the KOOS pain score at six, twelve, and twenty-four months; the KOOS symptom score at six months; the IKDC, KOOS sports, and visual analog scale (VAS) pain scores at twelve and twenty-four months; and the KOOS quality of life (QOL) score at twenty-four months. Analysis of covariance (ANCOVA) at one year indicated that the change in the KOOS pain (p = 0.016) and IKDC (p = 0.028) scores from pretreatment levels favored the NeoCart group. Significantly more NeoCart-treated patients (p = 0.0125) had responded to therapy (were therapeutic responders) at six months (43% versus 25% in the microfracture group) and twelve months (76% versus 22% in the microfracture group). This trend continued, as the proportion of NeoCart-treated patients (fifteen of nineteen) who were therapeutic responders at twenty-four months was greater than the proportion of microfracture-treated participants (four of nine) who were therapeutic responders at that time.

CONCLUSIONS:

This randomized study suggests that the safety of autologous cartilage tissue implantation, with use of the NeoCart technique, is similar to that of microfracture surgery and is associated with greater clinical efficacy at two years after treatment.

PMID: 22637204    [PubMed – indexed for MEDLINE]

 

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