Recent peer reviewed clinical study publication reveals high failure rates for biological knee cartilage treatments and thus highlights the need for alternative treatment options

The clinical paper A Randomized Multicenter Trial Comparing Autologous Chondrocyte Implantation
with Microfracture: Long-Term Follow-up at 14 to 15 Years, by Gunnar Knutsen, MD, PhD, Jon Olav Drogset, MD, PhD, Lars Engebretsen, MD, PhD, Torbjørn Grøntvedt, MD, PhD, Tom C. Ludvigsen, MD, Sverre Løken, MD, PhD, Eirik Solheim, MD, PhD, Torbjørn Strand, MD, and Oddmund Johansen, MD, PhD has been published in the Journal of Bone and Joint Surgery (J Bone Joint Surg Am, 2016;98:1332-9). Patients with cartilage injuries of the femoral condyles of the knee joint have been followed over a period of up to 15 years after biological treatment.

This information was published, 2016-10-18 14:10 CEST (GLOBE NEWSWIRE) —

The management of painful lesions of the articular cartilage and underlying bone in the knee remains problematic. One option is to undergo a biologic treatment referred to as autologous chondrocyte implantation (ACI), which involves harvesting cartilage cells during a first surgery, having these cells grown in a laboratory for a number of weeks and then having them implanted to the damaged cartilage zone during a second surgery. These patients have to undertake prolonged rehabilitation to allow the cells to start generating new hyaline cartilage.

Microfracturing is another biologic treatment for articular lesions of the knee joint, involving a surgeon to stimulate bone marrow to fill the damaged area and allowing the body to generate fibrocartilage, a less durable version of cartilage compared to the natural articular hyaline cartilage.

“In this recent publication Knutsen et al. report on their very well executed randomized clinical trial on autologous chondrocyte implantation vs. microfracturing with long-term follow-up.  They show a 43% failure rate for ACI vs. 33% for microfracturing at 15 years. 57% of the remaining patients in the ACI group and 48% of those patients in the microfracture group showed radiographic signs of early osteoarthritis, even though there were improvements in clinical scores (Lysholm score and VAS). We do not yet know the long-term results of the Episealer knee implant but there have been no revisions after 4 years. It is a consensus opinion in the field that secondary biologic procedures should not be an option. Therefore, these long term results put surgery for chondral lesions into perspective; failures are common and salvage procedures after such failures are in great want.  The Episealer implant may be an optimal salvage option after failed biology”, says Episurf’s Senior Medical Advisor Prof. Leif Ryd.

“With debilitating cartilage injuries continuing to cause patients problems with their day-to-day life, the Knutsen study supports that current biological treatment options can offer less than ideal results. Episurf can offer hope to these biologically failed patients” concludes Prof. Ryd.


For more information, please contact:

Rosemary Cunningham Thomas, CEO, Episurf Medical

Tel: +46 (0) 70-7655892

Tel: +44 (0) 7803-753603



About Episurf Medical

Episurf Medical is endeavoring to bring people with painful joint injuries a more active, healthier life through the availability of minimally invasive and personalized treatment alternatives. Episurf Medical’s Episealer® personalized implants and Epiguide® surgical drill guides are developed for treating localized cartilage injury in joints. Episurf Medical’s μiFidelity® system enables implants to be cost-efficiently tailored to each individual’s unique injury for the optimal fit and minimal intervention. Episurf Medical’s head office is in Stockholm, Sweden. Its share (EPIS B) is listed on Nasdaq Stockholm. For more information, go to the company’s website:

This information is information that Episurf Medical AB is obliged to make public pursuant to the EU Market Abuse Regulation. The information was submitted for publication, through the agency of the contact person set out above.