Acuitive Technologies
Breaking New Ground in Orthopedics

For decades, surgeons have desired to repair damaged bone and tissue with regenerative biomaterials. Unfortunately for the most part they have been relegated to using permanent devices like metal and PEEK. During the past three decades a trend toward biodegradable lactic and glycolic acid-based thermoplastic polymers have gained usage but have experienced a less than favourable result due to their mismatch in mechanical compliance, unpredictable degradation profile, and late-stage chronic inflammation.

Today, Acuitive Technologies is giving surgeons access to a superior alternative: an engineered biomaterial that participates in the healing process and overcomes the complications of traditional thermoplastic polymers.

Acuitive Technologies is making this feat possible with CITREGEN^®—a paradigm-changing synthetic biomaterial.

Our designs are unique because our material is unique. Our ability to think differently allows us to be innovative in how we engineer and bring products to market

Medical device manufacturer, Acuitive Technologies has developed CITREGEN^® to meet the goal of normal host tissue healing using regenerative engineering principles. CITREGEN’s key component is citrate, an anti-microbial and anti-inflammatory molecule integral to tissue anatomy, physiology, and regeneration.

Harnessing the power of its proprietary CITREGEN^® technology, Acuitive has developed a range of tendon and ligament reconstruction devices. To date, the company received FDA clearances for three products—the Citrelock^® tendon fixation device, Citrefix™ suture anchor, and the Citrelock ACL device.

The Citregen Advantage

CITREGEN, composed of citrate, calcium, and phosphate molecules, matches the structural, functional, and biomechanical properties of human bone. The current CITREGEN material comprises 60 percent bioceramic to mimic the native apatite content of human bone while still maintaining elasticity that matches cancellous bone.

Every tissue needs to be physiologically loaded and therefore the implant being used should closely match the tissue’s mechanical properties.

CITREGEN is versatile and can be designed on a molecular level to match the chemistry of the native tissue and mimic the crosslinked protein structure and citrated mineralization of the native extracellular matrix.

“As opposed to traditional thermoplastic implants that are subject to limitations, CITREGEN is the first and only bioresorbable thermoset polymer that participates with the specific tissue type being restored or regenerated,” says Dave Washburn, COO& Managing Partner of Acuitive Technologies.

CITREGEN is purposefully designed to replicate the intrinsic cellular support network by using a biomaterial-based regenerative engineering strategy that activates the body’s own regenerative mechanisms to recreate multi-tissue constructs.

CITREGEN can modify its form and function to meet the needs of the tissues being repaired, giving it a clear advantage over thermoplastics, which do not take part in the tissue regeneration process.

CITREGEN releases molecules essential to bone and tissue formation throughout its bioresorption process, leaving behind a biomimetic ceramic structure to be metabolized by the host tissue. CITREGEN resorption starts day one and the absorption of citrate increases cell energy production(bioenergetics) and its controlled and homogeneous resorption profile prevents bulk degradation and chronic inflammation.

Taking advantage of Citregen’s unique mechanical properties, Acuitive designed the Citrelock^® tendon interference device to mitigate tendon laceration. The unique soft fluted design is press-fit into place avoiding soft tissue damage that occurs with traditional threaded interference screws. The elastomeric nature of Citrelock™ supports a press-fit technique to maintain integrity of the tendon tissue while also providing stronger pull-out resistance. “Our designs are unique because our material is unique. Our ability to think differently allows us to be innovative in how we engineer and bring products to market. We try to match the physiologic properties of the tissue to assist with the regenerative process.” says Mike McCarthy, CCO and Managing Partner of Acuitive Technologies.

Catalyzing Surgeons’ Success

Packed with such powerful capabilities, CITREGEN has helped many surgeons cure bone deformities without medical complications. Wayne Berberian, M.D., an orthopedic surgeon at Hackensack University Medical Center, has utilized Acuitive Technologies’ devices to perform tendon transfer procedures in patients requiring ankle stabilization.

Impressed by the clinical outcomes, he started using Citrelock to treat more challenging patients with comorbidities like smoking, diabetes, and obesity, which negatively impact their healing ability.

Dr Berberian has continued to attain excellent results for his patients whose health conditions remained stable, and their healing process aided.

From Research To Recognition– Citregen’s Path To Wider Adoption?

To prove the bioactive potential of CITREGEN, Acuitive’s VP of Research, Richard Tran, Ph.D., has collaborated with CÚRAM, an Ireland-Based Research Institute, to highlight citrate’s role in regulating bone mineralization and tissue regeneration through cellular energy levels. The CÚRAM center investigated various stem cell-biomaterial interactions and determined that RNA sequencing activated numerous regenerative mechanisms. They also analyzed over 24,000 genes using ingenuity pathway analysis tools. Through this research, CITREGEN was found to be cytocompatible, and rich with properties that promote bone and soft tissue ingrowth at the implant site.

CITREGEN has also earned the Society for Biomaterials 2022 Technology Innovation and Development Award. This award recognizes an individual or team’s successful application of basic and applied biomaterials research in the development of a novel medical product or technology that significantly benefits the health and well-being of patients. The lead CITREGEN inventor, Guillermo Ameer, Sc.D., from Northwestern University, accepted this coveted award on behalf of the contributions made by his current and former research associates, including Penn State’s Jian Yang, Ph.D., who has devoted the past two decades to developing the CITREGEN biomaterial platform technology.

An Unwavering Commitment to Excellence

Acuitive continues to research and develop many more innovative products for even more challenging conditions such as rotator cuff repair and osteochondral repair with the Citrebridge^™ RC Scaffold and the Citreglide^™ Cartilage Device, respectively. The anticipated new product releases for 2023 include Citrewedge™ osteotomy wedge system, Citrepore^™ synthetic bone graft system and Citrelock Duo for soft tissue fixation. The mission to advance the art and science of orthopedic surgery is what drives Acuitive Technologies to develop such novel products.