By Marti Webb Slay
Patients with knee pain due to cartilage damage have a new treatment option, even if they suffer from arthritis, according to Orthopedic Surgeon Amit Momaya, MD, Chief of Sports Medicine at UAB. The
CartiHeal Agili-C cartilage repair implant, approved by the FDA in 2022, uses sea coral to help grow new tissue and bone. “The exoskeleton of sea coral is very similar to bone. It’s kind of cool that we’re using naturally occurring aragonite in nature to help human joints,” Momaya said.
The outpatient procedure entails drilling a small hole in the knee and plugging it with the Cartiheal implant, which serves as a scaffold on which cartilage and bone can regrow. The implant is resorbed within 18 months.
The effectiveness of the procedure has been proven. Studies show improved clinical outcomes over the surgical standard of care of debridement and microfracture, and patients are not as likely to need knee replacement surgery even four years after the procedure.
“Studies have followed patients for several years, randomizing them to either the traditional treatment versus this treatment,” Momaya said. “They found that the patients who had Cartiheal did much better, almost twice the reduction of pain and improvement in functional outcome scores compared to the standard group, at both two years and four years out from surgery. So it’s quite powerful.”
Momaya is one of the few surgeons in central Alabama who offers the procedure. An MRI, xray and physical exam can provide the necessary information to determine if a patient is a candidate for Cartiheal.
Momaya encourages anyone with knee pain to look into whether Cartiheal might be an option for them. “It’s patients with pain in the knee that have a cartilage issue going on,” he said. “People with mild to moderate arthritis can also use this procedure. Traditionally, we’ve had to stay away from people with arthritis when we do cartilage procedures, but this one works even if you have arthritis in the knee. It involves not only young people, but also older individuals. Traditionally, cartilage procedures were done only on younger people, but now we’ve used the implant on older people, and it’s worked really well too.”
The surgery is not long. “We typically go in first with a camera and confirm that there is a cartilage lesion that needs to be addressed. Once we confirm that, we usually make an open incision on the knee. That incision can range in length, but usually it’s no more than four to six centimeters. Then we put a pin in that area. We core it out to make a nice circle, and we put in the implant. We kind of pop it in, so you don’t have to have any screws to hold it in place. It actually just kind of pops right in like a puzzle piece and stays in. It takes about 30 minutes to do the procedure,” Momaya said.
Patients must use crutches or a rolling walker for the first two to four weeks following surgery. “After that, they can start walking normally, and the implant dissolves about 18 months after,” Momaya said. “But their outcomes start to improve dramatically even by three to six months, and we’re seeing really good outcome scores.
“It’s just a unique thing. When we can use something naturally occurring in nature to help, there’s a different level of excitement about it that. Sea coral is naturally occurring and very similar to our bone structure, so it’s very cool.”