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Effective treatment of cartilage defects in the knee for middle-aged patients is getting closer. Avalanche Medical, based at Brightlands Maastricht Health Campus, is on the eve of a crucial step with its self-developed SyCap, a plastic mini-prosthesis for treating a cartilage defect in the knee.

CEO Bindert Vriesema is confident, he said at the Brightlands TEFAF Symposium earlier this year. But he simultaneously tempers short-term expectations. “We are taking a careful approach and think we can start small-scale clinical trials in two to three years. Before we can treat large groups of patients, we will be about five or six years away because we first have to go through extensive clinical trials for market approval.”

Market approval takes time

“Market approval seems simple,” says Vriesema, “but this is what we have been working toward with our team since its inception in 2021. We are now finalizing the composition of the material, the production process, and the design. We are further optimizing the design with advanced computer models, developing a surgical toolset, and extensively testing the lifespan in mechanical test rigs. Because of the strict laws and regulations that apply to medical devices, we will also conduct a final animal test before we can start clinical trials.”

TU Eindhoven, Maastricht UMC+, DSM and InSciTe

The SyCap project, a collaboration between Maastricht UMC+, Eindhoven University of Technology, DSM, and the Chemelot InSciTe research institute, will start as early as 2015. “We were looking for a solution specifically for middle-aged patients since current treatments for this group do not provide the desired longevity. We increasingly see that patients are ready for a knee replacement too early, and we want to do something about that,” explains Dr. Pieter Emans, co-founder and Chief Medical Officer of Avalanche Medical and an orthopedic surgeon at MUMC+. “By repairing damaged cartilage at an early stage with a mini-prosthesis, we prevent further wear and tear of the joint. Think of filling a hole in the road with new asphalt before the hole gets bigger and bigger.”

Based on promising preclinical studies and widespread belief in the product from various hospitals, Avalanche Medical was established as a start-up company in 2021, and the team has settled on Brightlands Maastricht Health Campus. In 2024, the goal of treating the first patients is getting closer and closer.

Sustainable solution

“The SyCap implant is better than existing metal mini-prostheses,” Vriesema knows. “Our mini-prosthesis consists of polycarbonate-urethane, an advanced plastic developed by DSM. This type of plastic is almost as elastic as natural cartilage and, therefore, much kinder to the adjacent healthy tissues within the knee. In this way, we can prevent further wear and tear and provide longer life. Moreover, an MRI scan of the knee can always be made.”

The SyCap can also be used in other body parts such as shoulder, ankle and hand joints; basically anywhere cartilage gets damaged. Of course, the implant design must be looked at separately for each body part, but the concept remains the same.

Commercial market

The road to the commercial market is still long, the CEO knows. “Technically, I think the SyCap can be used by surgeons in a few years. However, first, only within clinical studies and then, depending on the clinical results, will market approval follow. Until then, of course, we will have no sales and incur many costs. In the first years we managed with various grants and loans, now we are looking for seed capital from investors and business angels. With that, we are getting a lot of help from the Brightlands network. We are being introduced to investors and getting input. We are confident our invention is going to help a lot of people.”