Arthritis is not a disease of the cartilage itself, but a disease of the subchondral bone beneath.

Nanoplasty for Arhthritis

TSG6 is the only biochemical with a chondroprotective designation. This serine protease inhibitor may be the key to cartilage restoration science and for that reason we concentrate it using a proprietary processor while strictly adhering to FDA guidelines for biologic treatments.

Our growth factor concentrate product, GFC6, forms the basis of our autologous thrombin activated scaffold, establishing a platform for cellular adhesion and cohesion. Signaling cells favor a hypoxic environment and thrive under scaffolded conditions when introduced into the relatively avascular subchondral bone.

We only use autologous thrombin. That means that when we activate the cell-seeded scaffold, we use your clotting proteins harvested at the beginning of the procedure with the aspiration.

The signaling cell procedure, Nanoplasty And Mechanical Axis Deviation, NAMAD® procedure and protocol was designed to restore native material properties to the diseased bone underlying cartilage destruction on the concave side of the joint.

We designed our minimally invasive percutaneous nanoplasty technique based on the fact that arthritis is not a disease of the cartilage itself, but a disease of the subchondral bone beneath.

Arthritis doesn’t progress past the cartilage softening stage known as chondromalacia until the bone beneath the cartilage becomes hard. This is a critical point in the progression of disease.

It’s not just the knee. In all synovial joints, the concave side of the joint takes the load from the convex side of the joint. This constant loading eventually strains the structure of cartilage past it’s breaking point. Cartilage cells are in a matrix of proteins called proteoglycans that attract water. The absorptive ability of cartilage gives it a spongy role in locomotion.

You can imagine that once the sponge wears through and can’t take the pounding anymore, the load goes into the bone beneath the cartilage. The body is amazing. In response to the layer of cartilage being breached, the immune system starts to recruit specialized cells to build a layer of supporting bone to keep the organism upright against gravity. With continued loading of the concave side of the joint, this bone gets thicker and more stiff. Eventually, it gets so stiff that the blood supply can’t reach the bone that has remodeled like marble. Relatively avascular bone becomes more stiff and eventually the load is reflected back to the convex side of the joint that starts pounding into the hard marble bone on the concave side of the joint.

You can imagine what happens next. The convex side of the joint that’s been pounding into concrete on the concave side starts to get stiff too. Any cartilage remaining once the convex side turns into a hard bone hammer is destroyed.

So what happens next if you do nothing? The joint takes about four years to break down once it starts to become painful from arthritis. Once the subchondral bone underneath the cartilage gets stiff, you’re on your way to having arthritis. The only way to prevent arthritis is to prevent the cause, hard subchondral bone.

Think of it like a baseball mitt (concave) catching a baseball (convex). The mitt absorbs the impact. If the mitt were much stiffer than the ball though, if it were made of steel for instance, then the load would be transferred back from the stiffer mitt to the softer ball, causing the ball to absorb the impact!

Author
S. Austin Yeargan III, MD Orthopedic Surgeon Molecular Immunobiologist

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