Selling CarboJet for Osteochondral Allograft – What You Need to Know

January 21, 2022

Dear Kinamed Agents and Sales Representatives,

Kinamed has seen a surge in interest in using CarboJet to improve outcomes in Osteochondral Allograft (OCA) procedures.  This is another great opportunity for you! Here’s what you Need to Know to Sell CarboJet for OCA.

First of all, what is an Osteochondral Allograft (OCA)?

OCA refers to the use of allograft bone and cartilage to treat osteochondral (i.e. bone and cartilage) defects. In the procedure, “plugs” (cylinders or dowels) of bone and overlying cartilage are harvested from an allograft bone and shaped on the back table and implanted into the recipient’s defect. Here is a short video showing the OCA shaping and implantation technique.

The Challenge:

One of the risks of an allograft procedure is delayed or incomplete incorporation of the graft due to an immune response by the recipient. Immunogenic elements contained in blood, fat, and marrow from the donor tissue are responsible for this type of rejection. According to a study by the famed Dr. Brian Cole at Rush University in Chicago (Effectiveness of Lavage Techniques in Removing Immunogenic Elements from Osteochondral Allografts), “Allograft bone and remaining marrow elements can stimulate an immune response in the host that may affect graft survival….there is tremendous interest in decreasing the amount of antigenic cellular material present in osteochondral allografts.”

Currently, surgeons use pulsatile lavage (on the back table) to attempt to clean out the donor bone prior to implantation, but as you know pulsatile lavage alone is not very effective at cleaning fat and marrow elements from cancellous bone.

 The Solution:

CarboJet’s effectiveness at removing blood, fat and marrow from cancellous bone is well documented. In the OCA procedure, CarboJet is used to “deep clean” the plug before implantation as shown in this video by Dr. Seth Sherman of Stanford University. This accomplishes two important goals:

• First, removal of immunogenic elements from the OCA Allograft. CarboJet has been shown to remove elements from Osteochondral Allografts more effectively than pulsed lavage alone. See figures 3 and 4 (below) from the study by Dr. Cole referenced above.

• Second, enhance the absorption of biologics into the OCA allograft. Not only can the presence of donor fat and fluids in the graft lead to an undesired immunogenic response, but it can limit the absorption of biologics like BMAC (bone marrow aspirate concentrate) or PRP (platelet rich plasma) that many surgeons apply to the allograft bone in order to accelerate and stimulate bone healing.

You can see this effect live in this video (Instagram account required) from Dr. Adam Yanke of Rush University.  This video demonstrates OCA preparation “With CarboJet”  vs. “Without CarboJet”. The screenshot below shows the significant improvement in BMAC integration when using CarboJet to prepare the Allograft vs. traditional saline lavage.  Note how the presence of lipids prevents the BMAC from being absorbed into the bone in the image on the left, whereas the image on the right demonstrates how the BMAC soaks into the bone “like a sponge”.

Screenshot from Dr. Yanke’s Instagram video

Dr. Sherman from Stanford shared the following video demonstrating the enhanced absorption of BMAC after CarboJet was used.

 Recent Success Story

Here’s a great example of how promoting this application can help you gain access to high value accounts:  Dr. Kris Jones of UCLA, who happens to be the head physician for the Los Angeles Lakers, had never heard of Kinamed until a few months ago.  After becoming interested in our MD3T system, the topic of OCAs arose since he performs quite a lot of these procedures. He agreed to try CarboJet.

In his first case, within seconds of applying CarboJet to the allograft plug, his gloves were covered with fat and marrow.  He immediately noticed and was impressed that:

1) so much of this material was present in these grafts even after thorough saline lavage, and

2) that CarboJet could be so effective at removing it.

Click here to view a video of Dr. Jones using CarboJet and see screen shot below.

Think about the premier sports medicine surgeons in your territory.  Could they be the key to gaining access to the most prestigious hospitals in your territory?  What could you do with that kind of access? Once CarboJet XF is available to Sports Medicine clinicians, your ability to demonstrate CarboJet’s benefits to total joint surgeons, at that same hospital or ASC, will be that much easier to accomplish.

Start taking advantage of this opportunity today by:

1. Identifying the surgeons that perform OCAs in your territory. Again, these are typically Sports Medicine surgeons. Here’s an example target list of some of the top Sports Medicine surgeons in the country: MOCA Surgeons | MOCA: Metrics of Osteochondral Allografts (mocagroup.org)
2. Sharing the above information with them
3. Scheduling an evaluation surgery

Feel free to contact me or your Director of Sales to discuss how to take advantage of this opportunity.

Best Regards,

Patrick Miller

Director of Sales, Pacific Region

Kinamed, Inc.

pmiller@kinamed.com

www.kinamed.com