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Cartilage Repair: What's the Right Combination?

START-UP counts some 40 commercial development efforts in cartilage repair and regeneration. Some are implanting synthetic scaffolds, and some are offering cell-based therapies used with or without scaffolds. It's a crowded and confusing category. So many companies are chasing a market that is still somewhat undefined and doesn't seem large enough to support them all. What's clear, however, is that almost 15 years after the introduction of Carticel, the first cell-based implant for cartilage repari, there is still an unsatisified market of patients aged 20-60 with knee pain due to cartilage damage or degeneration.

The recipe for hyaline cartilage—the slippery cartilage in the knee joint—is simple: seven parts water, two parts collagen, and one part glycoproteins. That simplicity, however, belies the complexity of how cartilage functions in the knee to keep the joint smoothly gliding under compression and shear forces, and is in contrast to just how difficult it has been for industry to come up with products to replace worn and injured cartilage.

Today, patients of all ages with knee pain due to degenerated cartilage can do very little to stave off the...

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