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Summer 2007

Regrowing Cartilage

Orthopaedic researchers at UCSF are testing a therapy to regrow damaged cartilage. The therapy involves growing patients' own cartilage cells outside the body, and then using them to repair damaged tissue. The experimental cartilage system they are working with, called NeoCart, is produced by the Waltham, Mass., company Histogenics.

Articular cartilage is a complex, highly structured tissue that is engineered to cushion large biomechanical loads. When damaged, articular cartilage is not easily repaired. The cells that make up cartilage don't easily reproduce. Damaged articular cartilage is often replaced by tissue called fibrocartilage, which is a tissue that is softer and less effective than the original tissue.

Current surgical treatments for damaged cartilage usually involve repair of torn cartilage or replacement of cartilage with donor tissue, but there has long been a dream of regrowing articular cartilage instead of replacing it. Some orthopaedic surgeons drill small holes in the bone to stimulate the growth of new cartilage, but the cartilage that grows is usually fibrocartilage instead of articular cartilage. Other investigators have tried to grow cartilage cells outside of the body, but the cells did not form articular cartilage consistently.

Histogenics has developed a system for taking healthy cartilage cells from a patient and growing them outside the body in a three-dimensional matrix. The cells are grown under pressure, simulating to some extent the environment in which they would grow in a joint. This allows the cells to actually form articular cartilage before implantation. After growth in an incubator, NeoCart tissue is transferred back to the patient and fixed in place with a collagen-laced biopolymer.

It is hoped that the NeoCart patch can improve the formation of articular cartilage, rather than fibrocartilage, in the joint. The NeoCart system, an investigational new product, is being tested at UCSF and four other medical centers as part of an FDA phase II clinical trial. UCSF orthopaedic surgeon C. Benjamin Ma, M.D., and the sports medicine team will be leading the trial.

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