Outcomes of bone marrow aspirate concentrate and matrix-induced chondrogenesis (BMIC) for treatment of osteochondral lesions of the talus

Kim, Bom Soo; Na, Yeop; Jang, Dong-Su

doi:10.1016/j.fas.2022.01.005

Cited by 3 publications

(5 citation statements)

References 24 publications

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“…85,102,104,119,134,138,185,186 d Significantly different from osteo(chondral) autograft transplantation therapies ( Q = 16.86, P < 0.0001), osteo(chondral) allograft transplantation therapies ( Q = 7.66, P = 0.0056), and metal implants ( Q = 9.29, P = 0.0023). 29,38,40,49,58,65,72,77,82,94,98,101,130,139,140,142,144,145,155,157,162,166,169,181,189,192,195,201,204 e Significantly different from metal implants ( Q = 3.95, P = 0.0468). 14,41,45,46,51,64,76,78 -80,86,99,103,107,112,114,115,124,133,147,179 …”

Section: Resultsmentioning

confidence: 96%

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The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

et al. 2023

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Objective The primary aim was to determine and compare the complication rate of different surgical treatment options for osteochondral lesions of the talus (OLTs). The secondary aim was to analyze and compare the severity and types of complications. Design A literature search was performed in MEDLINE (PubMed), EMBASE (Ovid), and the Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Primary outcome was the complication rate per surgical treatment option. Secondary outcomes included the severity (using the Modified Clavien-Dindo-Sink Complication Classification System for Orthopedic Surgery) and types of complications. The primary outcome, the severity, and the sub-analyses were analyzed using a random effects model. A moderator test for subgroup-analysis was used to determine differences. The types of complications were presented as rates. Results In all, 178 articles from the literature search were included for analysis, comprising 6,962 OLTs with a pooled mean age of 35.5 years and follow-up of 46.3 months. Methodological quality was fair. The overall complication rate was 5% (4%-6%; treatment group effect, P = 0.0015). Analysis resulted in rates from 3% (2%-4%) for matrix-assisted bone marrow stimulation to 15% (5%-35%) for metal implants. Nerve injury was the most observed complication. Conclusions In 1 out of 20 patients treated surgically for an OLT, a complication occurs. Metal implants have a significantly higher complication rate compared with other treatment modalities. No life-threatening complications were reported.

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Section: Resultsmentioning

confidence: 96%

“… d Significantly different from osteo(chondral) autograft transplantation therapies ( Q = 16.86, P < 0.0001), osteo(chondral) allograft transplantation therapies ( Q = 7.66, P = 0.0056), and metal implants ( Q = 9.29, P = 0.0023). 29,38,40,49,58,65,72,77,82,94,98,101,130,139,140,142,144,145,155,157,162,166,169,181,189,192,195,201,204 …”

Section: Resultsmentioning

confidence: 99%

The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

et al. 2023

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“…The characteristics of the included studies are shown in Table 1. There were 2 prospective cohort studies, 15,28 5 retrospective cohort studies, 16,23,25,45,46 and 2 case series 13,22 published with comparative surgical treatment of OLTs with and without cysts. A total of 165 patients with OLT who had cysts (cyst group) and 223 patients without cysts (noncyst group) were included, with a mean age of 36.77 years (range, 12-74 years) and a mean follow-up time of 33.44 months (range, 6-117 months).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies 15,23,25,28,46 compared postoperative VAS pain scores, including 286 patients (129 patients with cystic changes, 157 patients without). The included studies had no significant heterogeneity ( I 2 = 0%; P = .97).…”

Section: Resultsmentioning

confidence: 99%

“…The full text of 16 articles was then further assessed. Ultimately, 9 studies § met our eligibility criteria: 7 studies 13,15,16,22,25,28,45 reported AOFAS scores, 5 studies 15,23,25,28,46 included VAS pain scores with extractable data, and 3 studies 15,16,46 mentioned complications or adverse events. The details of the study selection process are shown in Figure 1.…”

Section: Literature Search Findingsmentioning

confidence: 99%

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Influence of Subchondral Cysts on the Outcomes of Surgical Treatment for Osteochondral Lesions of the Talus: A Systematic Review and Meta-analysis

Zhang,

Zheng,

Cai

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Limited literature is available regarding the effect of subchondral cysts on the surgical outcomes for treatment of osteochondral lesion of the talus (OLT). Purpose: To conduct a systematic review and meta-analysis of studies comparing surgical outcomes between OLTs with and without cysts. Study Design: Systematic review; Level of evidence, 4. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant studies published up to January 7, 2023. The 4375 retrieved studies were screened, and 9 articles (level of evidence, 2-4) were included, which comprised 165 patients with OLT and subchondral cysts (cyst group) and 223 without cysts (noncyst group). After data extraction, mean differences in outcome scores (American Orthopaedic Foot and Ankle Society [AOFAS] Ankle Hindfoot Scale, visual analog scale [VAS] score for pain) and adverse events were compared between the groups. Results: Functional scores improved after surgery in both groups, with the cyst group having a significantly higher AOFAS score than the noncyst group ( P = .005; I2 = 0%); subgroup analysis revealed that this difference was attributable to the size of the osteochondral lesion and the type of surgical procedure. No significant difference was found between the cyst and noncyst groups in VAS pain scores ( P = .77; I2 = 0%) or postoperative adverse events ( P = .35; I2 = 0%). Conclusion: The results of this review indicated that patients with subchondral cysts improved with surgical treatment of OLT. A relatively low level of evidence was available to indicate that surgical treatment for small OLTs with subchondral cysts will result in better clinical outcomes compared with OLTs without cysts.

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Autologous matrix‐induced chondrogenesis provides better outcomes in comparison to autologous minced cartilage implantation in the repair of knee chondral defects

Behrendt,

Eggeling,

Lindner

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeIn symptomatic mid‐sized focal chondral defects, autologous matrix‐induced chondrogenesis (AMIC) and minced cartilage implantation (MCI) offer two versatile treatment options. This study aimed to conduct a matched‐patient analysis of patient‐reported outcome measures to compare these two surgical treatment methods for focal chondral defects.MethodsAt the first centre, patients underwent a single‐stage procedure in which autologous cartilage was hand‐minced, implanted into the defect and fixed with fibrin glue. At the second centre, patients underwent AMIC, which was fixed in place with fibrin glue. All patients were seen 2–4 years postoperatively. Postoperative outcomes were assessed using the visual analogue scale for pain (VAS), the Lysholm score and the five domains of the knee osteoarthritis outcome score (KOOS). Patients from each surgical centre were matched by age, sex, defect size and defect localisation.ResultsIn total, 48 patients from two surgical centres (24 from each site) were matched for sex, age (MCI 30.3 ± 14.9 years vs. AMIC 30.8 ± 13.7 years) and defect size (MCI 2.49 ± 1.5 cm2 vs. AMIC 2.65 ± 1.1 cm2). Significantly better scores in the AMIC cohort were noted for VAS (p = 0.004), Lysholm (p = 0.043) and the KOOS subscales for pain (p = 0.016) and quality of life (p = 0.036). There was a significantly greater proportion of positive responders for Lysholm in the AMIC group (92%) compared with the MCI group (64%).ConclusionsThe AMIC procedure delivers superior patient outcomes compared with hand‐minced autologous cartilage implantation. These are mid‐term outcomes, with follow‐up between 2 and 4 years.Level of EvidenceLevel III.

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Outcomes of bone marrow aspirate concentrate and matrix-induced chondrogenesis (BMIC) for treatment of osteochondral lesions of the talus

Cited by 3 publications

References 24 publications

The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

Influence of Subchondral Cysts on the Outcomes of Surgical Treatment for Osteochondral Lesions of the Talus: A Systematic Review and Meta-analysis

Autologous matrix‐induced chondrogenesis provides better outcomes in comparison to autologous minced cartilage implantation in the repair of knee chondral defects

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