Autologous Chondrocyte Transplantation for Osteochondritis Dissecans of the Talus

Koulalis, Dimitrios; Schultz, W.; Heyden, Marcel A.G. van der

doi:10.1097/00003086-200202000-00021

Cited by 104 publications

(54 citation statements)

References 24 publications

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“…In comparison to the knee, few studies of periosteal-based ACI in the ankle joint report success rates varying from 81.2 % to 100 % [12][13][14][15][16]. In the longest follow-up found in literature, Giannini et al [17] accounted a series of ten patients (defect size 3.1 cm²) with a follow-up of ten years.…”

Section: Discussionmentioning

confidence: 99%

Treatment of deep articular talus lesions by matrix associated autologous chondrocyte implantation—results at five years

Anders

Goetz

Schubert

et al. 2012

International Orthopaedics (SICOT)

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Purpose Treatment of focal full-thickness chondral or osteochondral defects of the talus remains a challenge. The aim of this study was to evaluate the postoperative success and the long-term efficacy of matrix associated autologous chondrocyte implantation in these defects. Methods Matrix associated autologous chondrocyte implantation (MACI) was applied in 22 consecutive patients (mean age 23.9 years) with full-thickness chondral or osteochondral lesions of the talus. The average defect-size was 1.94 cm² (range 1-6). In case of osteochondritis dissecans (n013) an autologous bone graft was performed simultaneously. Follow-ups were routinely scheduled up to 63.5 (±7.4) months, consisting of clinical evaluation and magnetic resonance imaging. Results The AOFAS score improved significantly from 70.1 to 87.9/92.6/93.5/95.0/95.5 and 95.3 points at three, six, 12, 24, 36 and 63.5 months, respectively. On a visual analogue scale, pain intensity decreased from 5.7 (±2.6) to 0.9 (±0.8) while subjective function increased from 5.3 (±2.3) to 8.9 (±0.9) at final follow-up (each p<0.001). The Tegner score rose significantly from 2.4 (±1.2) to 4.7 (±0.6). The MOCART score improved from 62.6 (±19.4) at three months to 83.8 (±9.4) at final follow-up. No significant differences were found between lesions caused by osteochondritis dissecans or trauma and between first-or second-line treatments. For all scores, the most benefit was seen within the first 12 months with stable results afterwards. No major complications were noted. Conclusions Matrix associated autologous chondrocyte implantation is capable of significant and stable long-term improvement of pain and functional impairment caused by focal full-thickness chondral and osteochondral talus lesions.

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Section: Discussionmentioning

confidence: 99%

Treatment of deep articular talus lesions by matrix associated autologous chondrocyte implantation—results at five years

Anders

Goetz

Schubert

et al. 2012

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Several authors have reported favorable results at short-term follow-up. 39,146,229,315,448,457 However, long-term studies are needed to evaluate the effi cacy of this technique. Incomplete healing of subchondral cysts has been noted in some patients aft er ACI, although this did not adversely infl uence clinical outcomes at shortterm follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Although bone marrow stimulation had been applied for a long time and was considered the primary treatment, surgeons questioned the durability of the fi brocartilaginous repair tissue. 229,262 Furthermore, it was sometimes unclear which surgical approach to the OCD was most appropriate. Previous secondary treatments had disadvantages such as morbidity of the donor site and limited availability.…”

Section: Discussionmentioning

confidence: 99%

“…229,262 Th e primary aim of chapter 6 was to assess the long-term clinical and radiographic outcomes of arthroscopic debridement and bone marrow stimulation for talar OCDs. Fift y patients were evaluated aft er a mean follow-up of 12 years (range, 8 -20 years).…”

Section: Part II -Primary Arthroscopic Debridement and Bone Marrow Stmentioning

confidence: 99%

“…Th ere are concerns that the fi brocartilaginous tissue formed aft er bone marrow stimulation may be insuffi cient in the long term because it does not have the same biomechanical properties as native hyaline cartilage. 229,262 Th e authors of previous studies have attempted to identify prognostic factors associated with such treatment. Such factors included defect size, patient age, body mass index (BMI), history of trauma, and duration of symptoms.…”

mentioning

confidence: 99%

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