This study advances a cartilage-regeneration therapy designed to repair injured ankles while preserving mobility and function
SAN FRANCISCO, Oct. 30, 2026 /PRNewswire-PRWeb/ -- Stone Research Foundation (SRF) published clinical outcomes data supporting a much-needed solution for patients with severe ankle cartilage damage. The treatment called articular cartilage paste grafting (ArtCart) is designed to regenerate cartilage while preserving the natural joint's motion and function.
Published in the Journal of Cartilage & Joint Preservation, the study examines the articular cartilage paste graft technique adapted from the knee to the ankle for patients with post-traumatic cartilage loss and osteoarthritis. Ankle cartilage injuries make even walking a struggle. This work focuses on a longstanding problem in ankle care: the lack of durable treatments that offer patients relief without creating additional limitations.
Each patient in the study had been offered the standard choices for patients with ankle arthritis: live with the pain, ankle fusion, or ankle replacement.
Ankle fusion alleviates pain by permanently locking the ankle. Fusion, however, leads to arthritis in the surrounding joints due to the abnormal biomechanics created by fixing the tibia to the talus (reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC12417607. Significant progression of osteoarthritis in all three neighboring joints was found after fusion, including some that showed no arthritis before surgery. The effects of fusion can also carry into everyday life. In another clinical study, 80% of patients reported mobility issues and 60% indicated problems performing their usual daily activities after ankle fusion.
ArtCart takes a different approach by regenerating the damaged cartilage while keeping the patient's own ankle intact and functional. The minimally invasive procedure uses a small amount of the patient's healthy cartilage and bone, processes it into a paste in the operating room, and places it into the defect to help restore the joint surface.
The ankle application builds on approximately three decades of ArtCart development and investigation in the knee by Dr. Stone at The Stone Research Foundation in San Francisco, CA. Previous research demonstrated the technique's ability to repair cartilage, including regeneration of normal hyaline cartilage in treated knee patients. This provided the scientific basis for adapting ArtCart to the ankle, where complex cartilage loss remains particularly difficult to treat.
In this study, patients' mean pain score during activity fell over two years from 7.8 to 2.4 on a 10-point scale. Patients reported substantial improvements in grinding and stability. Four of five returned to higher-demand activities, including running, hiking, and high-impact sports.
"Severe arthritis can now be treated biologically with the intent of restoring motion and the goal of returning people to sports," said Kevin R. Stone, MD, founder and chairman of Stone Research Foundation and lead author of the study.
Longer-term follow-up demonstrated that among 20 patients, some followed for more than 15 years, none underwent fusion, replacement, or graft-related revision. All 20 avoided the lasting limitations of procedures that permanently lock or replace the ankle.
For Stone Research Foundation, this work advances the science of cartilage regeneration and fits its mission to accelerate healing, treat, prevent, and cure arthritis.
The study titled "Articular cartilage paste grafting for post-traumatic ankle cartilage lesions: five-patient case series" was published October 3, 2026, in the Journal of Cartilage & Joint Preservation by Elsevier on behalf of the International Cartilage Regeneration & Joint Preservation Society.
View the Research Paper | DOI: 10.1016/j.jcjp.2026.100325
About the Stone Research Foundation
The Stone Research Foundation is an independent, 501(c)(3) non-profit research institute pioneering regenerative orthopaedic treatments to stimulate the body's own healing properties to reduce the suffering of sports injuries and arthritis. The Stone Research Foundation performs bench science, in-vivo research, and outcome studies to measure the effectiveness and prove the scientific merit of new biologic approaches. We disseminate the results of this research worldwide through presentation, publication, and education in order that others may benefit and further advance the standard of care in orthopaedics.
https://www.stoneresearch.org/
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Media Contact
Katie Bourke, Stone Research Foundation, 1 (415) 921-1220, [email protected], https://www.stoneresearch.org/
SOURCE Stone Research Foundation
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