Stone Research Foundation Publishes Long-Term Study Results in Official ESSKA Journal

Patients avoid or delay knee replacement surgery with paste grafts

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Dr. Kevin R. Stone describes how an Articular Paste Graft procedure works.

SAN FRANCISCO--()--The Stone Research Foundation has published research confirming the long-term efficacy of the articular cartilage paste graft technique for repairing damaged and arthritic knees in the journal Knee Surgery, Sports Traumatology, Arthroscopy. This study covers patients a minimum of ten years to a maximum of twenty-three years after having a paste graft procedure. Outcomes reported include lasting improvements in pain, function and activity levels for an expected average of more than 16 years from having a paste graft.

For the subgroup of study patients who ultimately progressed to knee replacement surgery, treatment was able to delay arthroplasty from an average initial age of 45 until just over 60. Patients younger than 55 who have knee replacement surgery are at a 5 times greater risk of having to repeat the surgery.

Not surprisingly, surgeons are calling for improved methods to address the treatment gap for osteoarthritis patients under 60 who are physically active and not yet good candidates for knee replacement. This recently released research shows that the paste graft procedure, as a part of a biologic approach to orthopedic care, can empower relatively young people to realize their full potential—even after severe injuries.

“By following patients for ten or more years after a procedure, we get a strong evidence-based assessment of how long the benefits of the paste graft approach can be sustained. The study data exceeded our expectations. It shows how using this biologic solution can have a massive impact on younger patients, who wish to extend their athletic practices, and have unimpaired mobility, while delaying or permanently avoiding knee replacement surgery," says the study’s primary author, Dr. Kevin Stone.

Osteoarthritis is a serious health condition, affecting 30 million people in the USA, and is on the rise globally. Osteoarthritis’ signature is a progressive loss of cartilage in the joints, and underlying bone changes, resulting in pain and immobility. According to the CDC, nearly 1 in 2 people will develop symptomatic knee OA by the age of 85 years. For overweight people, the odds are worse: 2 out of every 3 obese people will develop osteoarthritis.

Adults with osteoarthritis report two to four times as many unhealthy days in the past month than those without arthritis, and significantly more depression.

The paste graft procedure is a unique, single-step outpatient procedure. It combines the patient’s own bone marrow progenitor cells with cells and matrix from articular cartilage and bone to form a scaffold for cartilage repair. This procedure has been used to salvage failed microfracture, OATS and drilling procedures that have been tried in the past. The paste graft procedure is also unusual in that there is no commercial product involvement. It can be performed with normal operating room equipment, and is therefore inexpensive. The results of the Stone Research Foundation study met or exceeded the results of any other published cartilage repair system study.

The full text of the study can be found at:

Knee Surgery, Sports Traumatology, Arthroscopy

ISSN 0942-2056
DOI 10.1007/s00167-016-4323-7

About the Stone Research Foundation

The Stone Research Foundation is dedicated to pushing the boundary of what is possible in orthopedics. We have a vision for the future in which stem cells, growth factors and biologic tissue solutions are commonly used to enhance the body’s natural healing ability, improving recovery times and outcomes for all patients. It is our goal to be able to provide repair of musculoskeletal problems to patients around the world—and especially in the developing world.


Articular cartilage · Knee · Osteoarthritis · Arthroscopy · Biologic knee repair · Autologous cartilage transplantation · Osteochondral grafting · Articular cartilage repair · Long-term clinical outcome · Survival analysis · Histology · Paste graft · Treatment gap · Orthobiologics · Cartilage reconstruction · Sports Medicine


Stone Research Foundation
Jonathan Pelsis, 1-415-563-3110

Release Summary

Research released following patient 10 to 23 years after paste graft instead of knee surgery.


Stone Research Foundation
Jonathan Pelsis, 1-415-563-3110