Denovo NT: The first Twenty
This is not a scientific article but the time is right for looking at my experience the last 2 years with Denovo NT. Twenty cases are between 4 months and two years out from surgery. The areas treated have all been either knee or ankle, and the knee has been treated in various locations ranging from the patella to both condyles.. All of these patients had significant pain preoperatively, and all had normal or nearly normal xrays.
The complications have included one blood clot, treated successfully with blood thinners, and one wound healing problem. This at first looked like an infection, but we were unable in spite of several attempts to culture any germs. In the end I washed out the knee and it healed fine. I am always looking for problems attributable to the tissue bank but as of yet I have been unable to document any cases (in over 2500 performed) of a tissue bank related infection, this according to the product manager at Zimmer, Inc.
The results have thusfar been superb. I am seeing early pain relief and good evidence of early “fill” of the cartilage lesions as demonstrated by MRI. Because of this, I am now about to fine tune the rehab program, and in some cases to allow earlier weight bearing (stopping the crutches). At present, there are no clinical failures; obviously this needs to be reassessed as more time passes. To date, none of the patients has had a secondary cartilage procedure.
One patient comment that keeps recurring is that for those patients who have had microfracture in the past, the Denovo NT procedure appears to offer greater pain relief, and sooner, than what they experienced previously. Of course, these patients did not do well with their microfracture procedure, so the sample is biased.
It should also be noted that I am performing Denovo NT through a very small incision- that last case was 1 ¼ inches long; concurrent with an arthroscopy. This is important to note when comparing my patients with others who may have been done differently.
At present, I am seldom performing ACI; the results of the DenovoNT procedures so far appear to be at least as favorable, and for about 1/10 the cost; not to mention one surgery instead of two.