Cartilage treatment
Apparatus is provided for treating hyaline cartilage of a subject, the apparatus including a chondral implant, which includes a first exposed electrode surface and which is configured to be implanted in osteochondral tissue of the subject. A second exposed electrode surface is configured to be implanted in a body of the subject. Control circuitry is configured to promote regeneration of the hyaline cartilage by driving the first and the second exposed electrode surfaces to drive nutrients toward the first exposed electrode surface. Other embodiments are also described.
1 . Apparatus for treating hyaline cartilage of a subject, the apparatus comprising:
a chondral implant, which comprises a first exposed electrode surface and which is configured to be implanted in osteochondral tissue of the subject;
a second exposed electrode surface, which is configured to be implanted in a body of the subject; and
control circuitry, which is configured to promote regeneration of the hyaline cartilage by cyclically:
driving the first and the second exposed electrode surfaces to electroosmotically drive fluid containing nutrients toward the first exposed electrode surface for periods of time having a duration of at least 3 minutes, and
providing rest periods during which the nutrient-containing fluid is not electroosmotically driven toward the first exposed electrode surface.
2 . The apparatus according to claim 1 , wherein the first exposed electrode surface has a surface area of 1-30 cm2.
3 . The apparatus according to claim 1 , wherein the control circuitry is configured to configure the first exposed electrode surface to be a cathode and the second exposed electrode surface to be an anode.
4 . The apparatus according to claim 1 , wherein the chondral implant comprises a synthetic scaffold, and wherein the first exposed electrode surface comprises an electrically-conductive material of the synthetic scaffold.
5 . The apparatus according to claim 4 , wherein the electrically-conductive material comprises carbon fiber.
6 . The apparatus according to claim 5 , wherein the carbon fiber is hollow carbon fiber.
7 . The apparatus according to claim 4 , wherein the electrically-conductive material comprises a biocompatible bioresorbable conductive porous material.
8 . The apparatus according to claim 4 , wherein the electrically-conductive material is shaped as a thin layer.
9 . The apparatus according to claim 1 , wherein the chondral implant comprises one or more synthetic materials that are configured to stimulate the hyaline cartilage regeneration.
10 . The apparatus according to claim 9 , wherein the chondral implant comprises a synthetic scaffold that is configured to stimulate the hyaline cartilage regeneration.
11 . The apparatus according to claim 10 , wherein the first exposed electrode surface is coupled to the synthetic scaffold, and wherein the chondral implant is configured to be implanted such that the first exposed electrode surface is located deeper within the osteochondral tissue than the synthetic scaffold.
12 . The apparatus according to claim 11 , wherein the synthetic scaffold is shaped as a thin layer.
13 . The apparatus according to claim 10 , wherein the synthetic scaffold comprises a layer of fibrin glue.
14 . The apparatus according to claim 10 , wherein the synthetic scaffold is biphasic.
15 . The apparatus according to claim 1 , wherein the chondral implant further comprises a tissue graft that is configured to stimulate the hyaline cartilage regeneration.
16 . The apparatus according to claim 15 , wherein the first exposed electrode surface is coupled to the tissue graft, and the chondral implant is configured to be implanted such that the first exposed electrode surface is located deeper within the osteochondral tissue than the tissue graft.
17 . The apparatus according to claim 1 , wherein the chondral implant is configured to be implanted in a chondral defect of the hyaline cartilage.
18 . The apparatus according to claim 17 , wherein the chondral implant comprises an osteochondral plug that is configured to stimulate the hyaline cartilage regeneration in the chondral defect.
19 . The apparatus according to claim 18 , wherein the first exposed electrode surface is located in a transition zone of the osteochondral plug between a chondral layer of the osteochondral plug and a subchondral bone layer of the osteochondral plug.
20 . The apparatus according to claim 18 , wherein the osteochondral plug comprises naturally-derived cartilage.
21 . The apparatus according to claim 18 , wherein the osteochondral plug comprises a biocompatible, artificial material.
22 . The apparatus according to claim 1 , wherein the control circuitry is configured to provide the rest periods having respective durations of at least 1 minute.
23 . Apparatus for treating hyaline cartilage of a subject, the apparatus comprising:
a chondral implant, which comprises a first exposed electrode surface and which is configured to be implanted in osteochondral tissue of the subject;
a second exposed electrode surface, which is configured to be implanted in a body of the subject; and
control circuitry, which is configured to promote regeneration of the hyaline cartilage by driving the first and the second exposed electrode surfaces to drive nutrients toward the first exposed electrode surface, by applying a voltage between the first and the second exposed electrode surfaces.
24 . The apparatus according to claim 23 , wherein the control circuitry is configured to drive the first and the second exposed electrode surfaces to electroosmotically drive fluid containing the nutrients toward the first exposed electrode surface.
25 . The apparatus according to claim 24 , wherein the control circuitry is configured to cyclically:
drive the first and the second exposed electrode surfaces to electroosmotically drive the nutrient-containing fluid toward the first exposed electrode surface, and
provide rest periods during which the nutrient-containing fluid is not electroosmotically driven toward the first exposed electrode surface.
26 . The apparatus according to claim 23 , wherein the voltage is 0.1-1.1 V.
27 . Apparatus for treating hyaline cartilage of a subject, the apparatus comprising:
a chondral implant, which comprises a first exposed electrode surface and which is configured to be implanted in osteochondral tissue of the subject;
a second exposed electrode surface, which is configured to be implanted in a body of the subject; and
control circuitry, which is configured to promote regeneration of the hyaline cartilage by cyclically:
driving the first and the second exposed electrode surfaces to electroosmotically drive fluid containing nutrients toward the first exposed electrode surface, and
providing rest periods during which the nutrient-containing fluid is not electroosmotically driven toward the first exposed electrode surface,
wherein the control circuitry is configured to sense a voltage between the first and the second exposed electrode surfaces during each of the rest periods, and upon detection of a reduction of the sensed voltage to below a threshold value, again begin electroosmotically driving the nutrient-containing fluid toward the first exposed electrode surface.