Founded in 2015, Subchondral Solutions, Inc. began by assembling a team with over 70+ years of surgical product development and commercialization, combined with over 40 years of device engineering and biomechanical research, with a vision of uncovering the underlying reason for failures or suboptimal outcomes in joint preservation surgical interventions. The literature, over the past 10 years, has repeatedly shown that the subchondral bone and cartilage work together as unit and depend on one another to preserve the health and function of the joint. The cartilage depends on the metabolic nutrients that are produced in the subchondral bone for its health. If the bone is compromised, (edema, trabecular fractures) it is unable to deliver the necessary nutrition to the cartilage and the health of the cartilage can therefore become compromised.
Derek Dee, MD is an Orthopedic Surgeon, trained in Sports Medicine and the founder of the S-Core® technology. He began to do research in 2012 with Thay Lee, PhD and a Professor in Medical Biomechanics, to better understand why patients would come to see him after having “gold standard” surgical intervention just a couple of years prior. The most common surgical interventions include microfracture and/or osteochondral allograft transfer (O.A.T.S). Dr. Dee’s theory, supported by Dr. Lee, is that to much focus on the repair of cartilage and and not enough on the subchondral bone. Biomechanical studies have shown that if the stress forces in a weight bearing joint are not dissipated over the entire joint, these forces can lead to focal damage to the cartilage as well as to the the bone, especially where the forces are the highest. If the surgical intervention does not account for these forces, then the pain and damage will return and the progression of osteoarthritis will continue and ultimately lead to end stage osteochondral disease.
The biomechanical solution for this problem was to develop some sort of an implant that could act as “rebar”, like what is used in concrete to dissipate forces and prevent fractures. The S-Core® Implant is made of titanium, one of the strongest metal alloys known and is widely used in medical due to both its strength and its properties making it inert in the body.
The next step was to develop the technology so that it would allow for the blood and marrow easily pass through the implant so that that the nutrients could reach the base plate of the cartilage to maintain its health, as well as to securely integrate into the bone. The S-Core® is threaded into the bone and is fenestrated on both sides and the top to allow for this metabolic communication. This was demonstrated and the company received its first FDA clearance in 2019.
S-Core® has been implanted in hundreds of patients in the past 2.5 years. The implant has proven to be very versatile and has broad indications. The implant is being used in upper extremity, lower extremity, and sports.