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A second technology, DeNOVO NT Graft ("Natural Tissue Graft"; Zimmer Inc, Warsaw, IN/ISTO Technologies Inc. St Louis, MO), is another application for cartilage regeneration using minced donated juvenile (<12 years of age) fresh allograft cartilage tissue obtained from human cadavers. During implantation, the minced cartilage tissue is mixed in a fibrin glue adhesive. This cartilage-fibrin construct is then implanted into the defect with an additional thin fibrin adhesive layer. Because of the minimal manipulation of the tissue, Denovo NT graft is classified as a 361hTC/P product not requiring FDA premarket approval (McCormick 2008). An observational prospective trial to study the outcome of the DeNOVO NT Graft procedure was begun in 2006 and is still recruiting participants (N=25). Randomized trials comparing this technique with standard methods have not been published and further study of this promising technique are needed to establish its safety and durable outcome benefit.