By Rivka Borochov
A torn knee ligament can be the end game for professional athletes. Tennis, soccer, and football players are particularly vulnerable to the most severe injury of a knee tendon–– a tear to the anterior cruciate ligament, or ACL.
A new Israeli-made ACL tendon implant made by the startup Tavor is on the market and now available at clinics in Turkey.
Tavor’s solution -- an artificial knee tendon called
Knee-T-Nol – cuts down on healing time, scarring and the risks inherent in current artificial tendons. It holds the promise of lifelike movement for a lifetime.
According to the US National Institutes of Health, an ACL tear is “an athlete’s nightmare.”
Usually caused by a sudden twisting motion, an ACL tear could take up to a year or more to heal if a patient decides to use his or her own or a donor’s tendon. Knee-T-Nol, made from an alloy called Nitinol, may help athletes jump back into the game within one, two or three months.
Inspired by products made for the stent industry, the Knee-T-Nol implant won’t suffer fatigue or “creep” –– processes that happen when rubbery materials lose elasticity after prolonged use. Scans on the 14 patients in Israel who have been using the implant over the last year reveal that it even seems to act as a scaffold for new growth.
“The idea here is that a knee implant should last a lifetime,” says Tavor CEO Idan Tobis. He claims his invention offers a fundamental shift in tendon repair.
Existing implants use artificial polymers that act like big rubber bands in the knee. Women especially are prone to the body’s immune response caused when chemicals from the polymers leak into the body over time.
ACL injuries commonly affect more women than men.
Serial biotech entrepreneur Tobis, who used to work for the large Israeli stent company Medinol, weighed all the options. He says that the knee implant business has been thinking “inside the box,” and that it’s time for a disruptive technology.
How it works
The implant looks like a dart when it goes into the body laparoscopically through three small incisions. Flexible, accordion-like metal tubing anchors the knee in place to the lower and upper bones, giving control and movement almost immediately.
The tubes are made from braided, super-elastic Nitinol strands. The result is springy artificial tendons close to the real thing. This may be the only solution that can salvage a professional sports career after injury, Tobis says.
One option for injured athletes who form part of the estimated $2 billion to $5 billion market of the hundreds of thousands of ACL injuries in the United States alone is the “do nothing,” career-ending option.
This choice means that the injured person will never be able to do more than run in a straight line.
Some patients try tendon replacement surgery using tendons from another part of the body, which requires two operations with the resulting pain and healing time.
“The standard healing phase is nine to 12 months or at best an accelerated six, seven or eight months,” says Tobis. That’s about a season, or a good chunk of one –– enough time off for promising athletes to look for other options.
Israel’s first Olympic gold medalist, judoka Yael Arad, saw the opportunity in this new Israeli invention and now supports Tavor with an investment and her business smarts.
Another investor is Dr. Preston Wolin, an orthopedic surgeon from Chicago who is the director and founder of the Center for Athletic Medicine. He has been the team doctor for DePaul University, Loyola University, University of Illinois-Chicago and other teams.
It will be at least a few years until Knee-T-Nol is available in the US. It currently has the European CE Mark and is now available in Turkey, where Tobis has developed partnerships with surgeons. He plans to expand the business throughout Europe and then Asia.