Articular cartilage repair using a resorbable matrix scaffold.

The creation of cartilage repair tissue relies on the implantation or neosynthesis of cartilage matrix elements. One cartilage repair strategy involves the implantation of bioabsorbable matrices that immediately fill a chondral or osteochondral defect. Such matrices support the local migration of chondrogenic or osteogenic cells that ultimately synthesize new ground substance. One such matrix scaffold, a synthetic resorbable biphasic implant (TruFit Plug; Smith & Nephew, San Antonio, TX), is a promising device for the treatment of osteochondral voids. The implant is intended to serve as a scaffold for native marrow elements and matrix ingrowth in chondral defect repair. The device is a resorbable tissue regeneration scaffold made predominantly from polylactide-coglycolide copolymer, calcium sulfate, and polyglycolide. It is approved in Europe for the treatment of acute focal articular cartilage or osteochondral defects but is approved by the US Food and Drug Administration only for backfill of osteochondral autograft sites. Preclinical studies demonstrated restoration of hyaline-like cartilage in a goat model with subchondral bony incorporation at 12 months. Early clinical results of patients enrolled in the Hospital for Special Surgery Cartilage Registry have been favorable, with a good safety profile.