the terms “ tissue ” is used in the general sense herein to mean any transplantable or implantable tissue , the survivability of which is improved by the methods described herein upon implantation . in particular , the overall durability and longevity of the implant are improved , and host - immune system mediated responses , are substantially eliminated . the terms “ transplant ” and “ implant ” are used interchangably to refer to tissue , material or cells ( xenogeneic or allogeneic ) which may be introduced into the body of a patient to replace or supplement the structure or function of the endogenous tissue . the terms “ autologous ” and “ autograft ” refer to tissue or cells which originate with or are derived from the recipient , whereas the terms “ allogeneic ” and “ allograft ” refer to cells and tissue which originate with or are derived from a donor of the same species as the recipient . the terms “ xenogeneic ” and “ xenograft ” refer to cells or tissue which originates with or is derived from a species other than that of the recipient . the term “ gel ” refers to a mixture of minced or milled pretreated allograft cartilage in a biocomposite carrier having a viscosity which is less than and is less rigid than a mixture of minced or milled pretreated allograft cartilage in a biocompatible carrier referred to by the terms “ putty ” or “ paste ” and contains less cartilage by weight than putty or paste . the present invention is directed towards a cartilage repair material and method of treatment . the preferred embodiment and best mode of the invention is shown in fig3 . in the production of the invention , allograft hyaline cartilage is lyophilized reducing its water content and milled for ease in application . after washes with sterile de - ionized ( di ) water , the cartilage material was frozen at − 20 ° to − 100 ° c . preferably − 70 ° c . and lyophilized to reduce the water content within the range of about 0 . 1 % to about 8 . 0 %. the cartilage is frozen with liquid nitrogen and ground into particles . a lesion or defect is removed by cutting a bore 50 or trimming a lesion in the implant area 100 and filling the bore 50 or lesion area with a milled cartilage mixture 20 of paste or gel consisting together with a biological carrier such as hyaluronic acid and its derivatives , gelatin , collagen , chitosan , alginate , buffered pbs , dextran , or polymers and one or more additives namely chondrogenic stimulating factors including , but not limited to growth factors ( fgf - 2 , fgf - 5 , igf - 1 , tgf - β , bmp - 2 , bmp - 7 , pdgf , vegf ), human allogenic or autologous chondrocytes , human allogenic cells , human allogenic or autologous bone marrow cells , human allogenic or autologous stem cells , demineralized bone matrix , insulin , insulin - like growth factor - 1 , interleukin - 1 receptor antagonist , hepatocyte growth factor , platelet - derived growth factor , indian hedgehog and parathyroid hormone - related peptide . suitable organic glue material can be used to keep the viscous cartilage mixture 20 fixed in place in the implant area or to affix a periosteal cap 30 in place over the surrounding hyaline cartilage area 100 . suitable organic glue material can be found commercially , such as for example ; tisseel ® or tissucol ®) ( fibrin based adhesive ; immuno ag , austria ), adhesive protein ( sigma chemical , usa ), and dow corning medical adhesive b ( dow corning , usa ). a matrix of minced cartilage putty consisting of minced or milled allograft articular cartilage which has been lyophilized so that its water content ranges from 0 . 1 % to 8 . 0 % with a cartilage content ranging from 25 % to 50 % by weight is mixed with a carrier of sodium hyaluronate solution ( ha ) ( molecular weight ranging from 7 . 0 × 10 5 to 1 . 2 × 10 6 ) or any other bioabsorbable carrier such as hyaluronic acid and its derivatives , gelatin , collagen , chitosan , alginate , buffered pbs , dextran , or polymers , the carrier ranging from 75 % to 50 % by weight . the cartilage is milled to a size ranging from 0 . 01 mm to 1 mm . in gel form , the minced cartilage which has been lyophilized so that its water content ranges from 0 . 1 % to 8 . 0 % ranging from 15 % to 30 % by weight and the carrier ranges from 85 % to 70 % by weight . the particle size of the cartilage when milled is less than or equal to 1 mm dry in the previously stated range . the cartilage pieces can be processed to varying particle sizes and the ha or other carrier can have different viscosities depending on the desired consistency of the putty or paste . this cartilage matrix can be deposited into the cartilage defect arthroscopically and fit into the defect where it is held in place by it &# 39 ; s own viscosity , mixed with fibrin glue or covered with a periosteal or perichondrial flap , then sealed with biological glue . as with the first two matrices , this matrix can support the previously mentioned chondrogenic factors . a matrix of minced cartilage putty consisting of minced or milled allograft cartilage which has been lyophilized so that its water content ranges from 0 . 1 % to 8 . 0 % ranging from 25 % to 50 % by weight is mixed with a carrier of sodium hyaluronate solution ( ha ) ( 7 . 0 × 10 5 to 1 . 2 × 10 6 ) or any other bioabsorbable carrier such as hyaluronic acid and its derivatives , gelatin , collagen , chitosan , alginate , buffered pbs , dextran , or polymers ranging from 75 % to 50 % by weight . in a gel form , the minced cartilage which has been lyophilized so that its water content ranges from 0 . 01 % to 8 . 0 % ranging from 15 % to 30 % by weight and the carrier ranges from 85 % to 70 % by weight . the particle size of the cartilage is less than or equal to 1 mm dry ranging from 0 . 01 mm to 1 mm . the cartilage pieces can be processed to varying particle sizes and the ha or carrier can have different viscosities depending on the desired consistency of the putty or paste . autologous or allogenic cells which have been grown outside the patient are inserted by syringe into the matrix before , during or after deposit of the cartilage matrix into the defect area . such cells include allogenic or autologous bone marrow cells , stem cells and chondrocyte cells . the cellular density of the cells preferably ranges from about 1 × 10 8 to 5 × 10 8 or from about 100 million to about 500 million cells per cc of putty or gel mixture . this composite material can be injected into the cartilage defect arthroscopically and fit into the defect where it is held in place by it &# 39 ; s own viscosity , or covered with a periosteal or perichondrial flap , then sealed with biological glue . as with the first matrix , this matrix can support the previously mentioned chondrogenic factors . the operation of placing the cartilage composition in a cartilage defect , comprises ( a ) cutting a patient &# 39 ; s tissue at a site of a cartilage defect to remove the diseased area of cartilage ; ( b ) placing a mixture of milled allograft cartilage in a bioabsorbable carrier in the defect area ; and ( c ) placing a periosteal cover over the mixture of the inserted milled allograft cartilage in a bioabsorbable carrier to contain the mixture in the defect area for a predetermined period of time to promote cartilage growth at the defect site . alternate steps include the addition of growth factors , chondrocytes , bone marrow cells and stem cells . the principles , preferred embodiments and modes of operation of the present invention have been described in the foregoing specification . however , the invention should not be construed as limited to the particular embodiments which have been described above . instead , the embodiments described here should be regarded as illustrative rather than restrictive .
the invention is directed toward a sterile cartilage defect implant material comprising milled lyophilized allograft cartilage pieces ranging from 0 . 01 mm to 1 . 0 mm in size in a bioabsorbable carrier taken from a group consisting of sodium hyaluronate , hyaluronic acid and its derivatives , gelatin , collagen , chitosan , alginate , buffered pbs , dextran or polymers with allogenic chondrocytes or bone marrow cells in an amount exceeding the natural occurrence of same in hyaline cartilage and adding a cell growth additive .