The Unmet Need

650,000 patients with an isolated cartilage defect in the knee are surgically treated each year in the USA and Europe combined. Approximately 50% of these cartilage defects are found in patients aged between 40-60 years [1], which amounts to over 325,000 affected middle-aged patients per year. Approximately 15% of all cartilage repair procedures fail and require reoperation. Focal knee cartilage defects lead to severe disabling joint pain and impair quality of life to the same extent as advanced osteoarthritis (OA) [2]. If focal cartilage defects are left untreated, cartilage damage will progress [3], leading to symptomatic and radiographic osteoarthritis in the long term [4]. Patients demand a treatment that provides full functional restoration with a minimal rehabilitation duration, without recurrence of symptoms or the need for future surgical procedures. As regenerative capacity is detrimentally affected beyond the age of 40 or after failed cartilage repair surgery, regenerative cartilage repair therapies are ineffective in these patient groups. No effective and demand-satisfying treatment thus exists currently for patients between 40-60 years of age or for those who have previously undergone a prior failed cartilage repair procedure.

[1] C.N. Engen, A. Aroen, L. Engebretsen, Incidence of knee cartilage surgery in Norway, 2008-2011, BMJ Open 5(11) (2015) e008423.
[2] S. Heir, T.K. Nerhus, J.H. Rotterud, et al., Focal cartilage defects in the knee impair quality of life as much as severe osteoarthritis: a comparison of knee injury and osteoarthritis outcome score in 4 patient categories scheduled for knee surgery, Am J Sports Med 38(2) (2010) 231-7.
[3] D.A. Houck, M.J. Kraeutler, J.W. Belk, R.M. Frank, E.C. McCarty, J.T. Bravman, Do Focal Chondral Defects of the Knee Increase the Risk for Progression to Osteoarthritis? A Review of the Literature, Orthop J Sports Med 6(10) (2018) 2325967118801931.
[4] K. Messner, W. Maletius, The long-term prognosis for severe damage to weight-bearing cartilage in the knee: a 14-year clinical and radiographic follow-up in 28 young athletes, Acta Orthop Scand 67(2) (1996) 165-8.

Our Product

Avalanche Medical is developing a biomimetic, non-degradable polymer focal knee resurfacing implant intended to treat cartilage defects in middle-aged patients. The SyCap implant’s mechanical and tribological properties ensure wear resistance, long-lasting functional restoration and pain relief, without inducing damage to the opposing cartilage or potentially loosening by stress-shielding. The implant allows for immediate load bearing, and can be introduced surgically via a minorly invasive procedure. This minimizes rehabilitation time and ensures a quick return to work. The polymer implant is radiopaque (visible on X-ray) and is fully magnetic resonance imaging (MRI)-compatible, thereby allowing for unrestricted future diagnostic imaging. If revision or conversion is necessary for any reason (e.g. progression of cartilage damage to osteoarthritits), the SyCap implant can easily be converted to a larger implant or hemi-/total knee arthroplasty.