“Many of Americans like McHatton deal with chronic knee pain. The culprit nearly always is injured cartilage — the elastic, almost Jell-O-like substance that protects the joints and bones of the human body. More than 30 million Americans suffer from osteoarthritis, a wear-and-tear condition that occurs when cartilage withers away, a defect especially prevalent in the knee. The last-resort treatment for those with bum knees is replacement surgery. According to the Academy of Orthopaedic Surgeons, more than 600,000 Americans get new knees made of metal every year. Indeed, total knee replacement is now the most common inpatient surgery for people over 45.

But why replace a knee if just the cartilage can be repaired instead? …

Wiley and colleague Ken Gall, a professor of mechanical engineering and materials science at Duke, are instead trying to re-create cartilage in the lab. Over the last several years they’ve developed a hydrogel composed of polyvinyl alcohol, a polymer often used in contact lenses, and cellulose fibers. Tests in a compression machine, Wiley says, demonstrated that the product could support 1,100 pounds of force, simulating five years of use. The hydrogel, which is pressed into the end of the femur bone, is being used in a Phase 1 human trial in Latin America. Wiley and Gall hope to get the green light to begin human trials in the United States sometime next year.

The coral option was presented to McHatton after a failed surgery called MACI, the acronym for a matrix-induced autologous chondrocyte implantation, a procedure approved by the Food and Drug Administration in 2016. It involves removing cartilage cells from the knee, regrowing them in a lab, and embedding them on a membrane of collagen that is then implanted. At $40,000, the surgery is expensive for those without insurance. It’s also intensive: McHatton was lying in bed for a month because she couldn’t put any weight on her left knee. It’s also generally recommended that people avoid activities like running for almost a year afterward. In some cases, the implanted cartilage doesn’t take — which is what happened to McHatton.

The coral plug, by contrast, took a little more than an hour to put in and cost her $200 out of pocket (insurance covered the rest). Over time, the coral will be fully absorbed by her bone, and in its place will be a gooey substance composed of stem cells from her femur bone that acts similarly to natural cartilage. Full recovery is supposed to take two years, but McHatton says she’s already back to bike-riding, hiking and 12-hour shifts at the hospital.”

From Washington Post.