DeNovo NT Allograft

Articular cartilage repair is a continually evolving and often controversial area of sports medicine as the result of variable outcomes, contrasting opinions, and lack of a single reliable resurfacing option in this often complex heterogeneous patient population. Although many articular cartilage lesions are asymptomatic, others cause significant disability in patients who are not optimal candidates for arthroplasty procedures. To address this subset of patients, many techniques have evolved in an effort to repair chondral or osteochondral lesions. Current techniques that are most commonly used include microfracture, autologous osteochondral transfer, autologous chondrocyte implantation (ACI), and allograft osteochondral transplantation. In general, the literature demonstrates fair to good results for these various procedures performed in appropriate patients. However, there is significant variation and controversy in the literature and amongst peers regarding the outcomes, indications for, and resultant repair tissue generated with some of these procedures. Concomitant procedures such as unloading osteotomies or realignment procedures, which may be integral to the success of an articular resurfacing procedure, also create patient heterogeneity when interpreting results. Inherent to each of the current treatment options are drawbacks or limitations, and thus, modification of these techniques vs the development of novel procedures are continually explored. More recent techniques for cartilage repair include subsequent generations of ACI, tissueengineered constructs, as well as techniques utilizing minced or particulated cartilage fragments. One of the minced cartilage techniques, termed DeNovo NT (natural tissue), utilizes juvenile articular cartilage and has been commercially available since 2007. The viable articular cartilage allograft is harvested from juvenile donors, particulated into chondral fragments, and maintained in storage medium between 191C and 261C for up to 49 days (procurement to current expiration date). The particulated allograft chondral fragments are subsequently secured into recipient patient defects in a single-stage procedure utilizing fibrin adhesive.