A Comparison of Outcomes of Particulated Juvenile Articular Cartilage and Bone Marrow Aspirate Concentrate for Articular Cartilage Lesions of the Talus

Lanham, Nathan S; Carroll, John J.; Cooper, Minton Truitt; Perumal, Venkat; Park, Joseph S.

doi:10.1177/1938640016679697

Cited by 28 publications

(34 citation statements)

References 30 publications

(60 reference statements)

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“…The overall clinical outcomes in our study parallel the current limited data on PJCAT for treatment of OCLTs. 8,10,23,36,37 However, some authors have reported on PJCAT with concomitant procedures such as realignment osteotomies and ligamentous stabilizations. 8,36,37 In the current study, overall patient-reported ankle pain improved significantly by 51%, compared to preoperative levels following PJCAT for treatment of symptomatic OCLTs.…”

Section: Discussionmentioning

confidence: 99%

“…With PJCAT for treatment of OCLTs in its nascent adoption, there is a paucity of literature regarding intermediate or even short-term outcomes following its use. 4,8,10,23,36,37 Three retrospective series have demonstrated encouraging short-term clinical and functional outcomes following arthroscopic and open PJCAT. 8,10,36 Two of these series were confounded by concomitant procedures other than isolated PJCAT.…”

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confidence: 99%

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Outcomes and Predictors of Postoperative Pain Improvement Following Particulated Juvenile Cartilage Allograft Transplant for Osteochondral Lesions of the Talus

et al. 2020

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Background: Particulated juvenile cartilage allograft transfer (PJCAT) is an emerging treatment option for management of osteochondral lesions of the talus (OCLTs). This series reports on outcomes and identifies predictors for success following PJCAT for isolated OCLTs. Methods: We reviewed 33 consecutive patients who underwent PJCAT by a single surgeon from 2013 to 2017. Preoperative demographic factors (age, body mass index [BMI], tobacco use, behavioral health comorbidity, and ankle pain visual analog score [VAS]) and OCLT morphologic data were collected. Outcomes included postoperative improvements in VAS and American Orthopaedic Foot & Ankle Society (AOFAS) score and clinical success/failure. Results of 7 second-look arthroscopies and complications are provided. Categorical data are reported as frequencies, and statistical means with P values are reported for continuous variables. We had a mean 3.5 years of follow-up. Results: Improvement in ankle pain VAS following isolated PJCAT was 51% ( P < .001). For the first 16 consecutive patients in whom complete AOFAS scores were available, 40% ( P < .001) improvement occurred. Presence of 1 or more behavioral health diagnoses was a risk factor for decreased pain relief, while moderate to severe preoperative pain (VAS >5.9) predicted improved postoperative pain relief. Age, BMI, tobacco use, and OCLT morphology did not affect outcomes. Conclusion: For treatment of large, high-stage OCLTs, PJCAT resulted in 40% to 50% improvement in ankle pain and disability within 3.5 years. The results may be better in patients with moderate to severe preoperative pain but worse in those with preexisting behavioral health diagnoses. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Outcomes and Predictors of Postoperative Pain Improvement Following Particulated Juvenile Cartilage Allograft Transplant for Osteochondral Lesions of the Talus

et al. 2020

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“…These were conducted in either the knee [71, 72] or the ankle joint [73, 74] (Table 2). Microfracture was the main marrow stimulation technique, applied in three studies [71–73], subchondral drilling only once [74]. In all the investigations, BMA was harvested from the iliac crest and processed with various commercially available centrifuge systems to generate BMAC.…”

Section: Effects Of Bone Marrow Aspirate-enhanced Marrow Stimulatimentioning

confidence: 99%

“…MRI also revealed that BMAC-enhanced microfracture induced significantly less fissuring and fibrillation of the articular cartilage surface than microfracture treatment without adjunct. Lanham et al evaluated 12 patients with full-thickness chondral defects of the talus (6-7 mm in depth) treated either with BMAC-enhanced subchondral drilling covered by a collagen scaffold or with particulated juvenile articular cartilage [74]. The collagen scaffold consisted of a hydrated matrix of bovine collagen and glycosaminoglycans.…”

Section: Effects Of Bone Marrow Aspirate-enhanced Marrow Stimulatimentioning

confidence: 99%

Bone Marrow Aspirate Concentrate-Enhanced Marrow Stimulation of Chondral Defects

Madry

Eichler

Orth

et al. 2017

Stem Cells International

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Mesenchymal stem cells (MSCs) from bone marrow play a critical role in osteochondral repair. A bone marrow clot forms within the cartilage defect either as a result of marrow stimulation or during the course of the spontaneous repair of osteochondral defects. Mobilized pluripotent MSCs from the subchondral bone migrate into the defect filled with the clot, differentiate into chondrocytes and osteoblasts, and form a repair tissue over time. The additional application of a bone marrow aspirate (BMA) to the procedure of marrow stimulation is thought to enhance cartilage repair as it may provide both an additional cell population capable of chondrogenesis and a source of growth factors stimulating cartilage repair. Moreover, the BMA clot provides a three-dimensional environment, possibly further supporting chondrogenesis and protecting the subchondral bone from structural alterations. The purpose of this review is to bridge the gap in our understanding between the basic science knowledge on MSCs and BMA and the clinical and technical aspects of marrow stimulation-based cartilage repair by examining available data on the role and mechanisms of MSCs and BMA in osteochondral repair. Implications of findings from both translational and clinical studies using BMA concentrate-enhanced marrow stimulation are discussed.

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“…Improvement was seen in pain and function. 1,8,12,14,16 The purpose of this article was to evaluate clinical and functional outcomes after the use of PJCAT and to identify patient and OLT attributes that influence outcomes following this technique. We hypothesized that PJCAT would be a safe and effective treatment for OLTs.…”

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confidence: 99%

Efficacy of Particulated Juvenile Cartilage Allograft Transplantation for Osteochondral Lesions of the Talus

et al. 2017

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A Comparison of Outcomes of Particulated Juvenile Articular Cartilage and Bone Marrow Aspirate Concentrate for Articular Cartilage Lesions of the Talus

Abstract: Therapeutic, Level IV: Retrospective, Case series.

Cited by 28 publications

References 30 publications

Outcomes and Predictors of Postoperative Pain Improvement Following Particulated Juvenile Cartilage Allograft Transplant for Osteochondral Lesions of the Talus

Outcomes and Predictors of Postoperative Pain Improvement Following Particulated Juvenile Cartilage Allograft Transplant for Osteochondral Lesions of the Talus

Bone Marrow Aspirate Concentrate-Enhanced Marrow Stimulation of Chondral Defects

Efficacy of Particulated Juvenile Cartilage Allograft Transplantation for Osteochondral Lesions of the Talus

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