Biologic Implant Regrows Cartilage and Bone

A novel cell-free biomaterial implant repairs cartilage and osteochondral defects in both traumatic and osteoarthritic joints.

The CartiHeal (Kfar Saba, Israel) Agili-C implant is designed to provide a scaffold that reproducibly regenerates hyaline cartilage and its underlying subchondral bone in a single-step procedure. Once the size of the defect is determined, a cavity is prepared in the affected area and the implant is inserted in a press fit manner. Blood immediately infiltrates the implant’s interconnected pores, initiating a biological cascade culminating in bone and hyaline cartilage regeneration through migration, adhesion, proliferation, and differentiation of mesenchymal stem cells (MSCs).

Within a few months, the top layer turns into true hyaline cartilage, while the bottom layer turns to bone, with each tissue genetically identical to the body’s own tissues. The regenerated cells gradually biodegrade the implanted scaffold over time. The rigid, bi-phasic implant is made of biocompatible and biodegradable aragonite, a naturally occurring crystal form of calcium carbonate (CaCO3) that forms the backbone of coral. The bone phase of the implant is composed of CaCO3 in crystalline form, and the cartilage phase is a composite of modified aragonite and hyaluronic acid (HA).

“Cartilage has very limited ability to be repaired. Finding a solution for cartilage regeneration is one of the holy grails of medicine. Millions of patients are looking for a solution to the degeneration of knee cartilage. We hope we can provide a breakthrough with our technology,” said Nir Altschuler, CEO and founder of CartiHeal. “Cartilage and bone cells adhere to the implant, while at the same time gradually degrading the calcium from the scaffold. Eventually the implant is almost fully degraded as bone and cartilage regrow.”

“As orthopedic surgeons, our goal is to prevent further erosion or cartilage damage within the knee, by promoting the growth of healthy cartilage,” said Guy Morag, MD, director of the sports medicine unit at Sourasky Medical Center (Tel Aviv, Israel), who is participating in CartiHeal's pivotal U.S. Food and Drug Administration (FDA) investigational device exemption (IDE) study. “The Agili-C implant leads to formation of high quality articular cartilage as well as underlying subchondral bone, which we haven't been able to achieve with other available modalities.”

CaCO3 is a common substance found in sedimentary rocks in mineral form, such as calcite and aragonite, most notably as limestone. It is also the main component in the shells of marine organisms, snails, and eggs. Marine CaCO3 skeletons, such as coral, have an architecture that gives them structural support and other functions. For example, seashells have dense lamellar structures, while coral, cuttlebone, and sea urchin spines have interconnected porous structures.

Related Links:
CartiHeal
Sourasky Medical Center