Platelet-Rich Plasma and Concentrated Bone Marrow Aspirate in Surgical Treatment for Osteochondral Lesions of the Talus

Yasui, Youichi; Ross, Andrew; Kennedy, John G.

doi:10.1016/j.fcl.2016.07.010

Cited by 13 publications

(8 citation statements)

References 63 publications

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“…106 Platelet-rich plasma. PRP is an autologous product of concentrated blood plasma that contains at least twice of the normal platelet concentration in blood and contains of several growth factors and cytokines [166][167][168][169] and is produced with a bedside procedure concentrating PRP from autologous blood samples for individual use. Thus, the concentration is differing from individual to individual.…”

Section: Biologics: Scaffolds Platelet-rich Plasma (Prp) and Bone Marrow Aspirate Concentrate (Bmac)mentioning

confidence: 99%

“…PRP contains different growth-factors such as transforming growth factor-β1 (TGF-β1), fibroblast growth factor (FGF), epidermal growth factor (EGF), platelet-derived growth factor (PDGF), and vascular endothelial growth factor (VEGF). [166][167][168][169][170] These factors are capable for the proliferation of chondrocytes in a porcine model 171 and human PRP stimulates migration and chondrogenic proliferation of subchondral progenitor cells. 172 In addition, PRP has also been used in orthopedic surgery with the purpose to improving the healing process in different tissues such as tendons, bone, and cartilage or musculoskeletal disorders either as a single agent or as an adjunct in combination with BMAC.…”

Section: Biologics: Scaffolds Platelet-rich Plasma (Prp) and Bone Marrow Aspirate Concentrate (Bmac)mentioning

confidence: 99%

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Osteochondral Lesions of the Talus: A Review on Talus Osteochondral Injuries, Including Osteochondritis Dissecans

Bruns¹,

Habermann

Werner

2021

CARTILAGE

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This is a review on talus osteochondritis dissecans and talus osteochondral lesions. A majority of the osteochondral lesions are associated with trauma while the cause of pure osteochondritis dissecans is still much discussed with a possible cause being repetitive microtraumas associated with vascular disturbances causing subchondral bone necrosis and disability. Symptomatic nondisplaced osteochondral lesions can often be treated conservatively in children and adolescents while such treatment is less successful in adults. Surgical treatment is indicated when there is an unstable cartilage fragment. There are a large number of different operative technique options with no number one technique to be recommended. Most techniques have been presented in level II to IV studies with a low number of patients with short follow ups and few randomized comparisons exist. The actual situation in treating osteochondral lesions in the ankle is presented and discussed.

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Section: Biologics: Scaffolds Platelet-rich Plasma (Prp) and Bone Marrow Aspirate Concentrate (Bmac)mentioning

confidence: 99%

Section: Biologics: Scaffolds Platelet-rich Plasma (Prp) and Bone Marrow Aspirate Concentrate (Bmac)mentioning

confidence: 99%

Osteochondral Lesions of the Talus: A Review on Talus Osteochondral Injuries, Including Osteochondritis Dissecans

Bruns¹,

Habermann

Werner

2021

CARTILAGE

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“…The rate of return to sporting activities in the few studies exclusively assessing athletes has been as low as 63%. 22…”

mentioning

confidence: 99%

Autologous Osteochondral Transplantation for Large Osteochondral Lesions of the Talus Is a Viable Option in an Athletic Population

et al. 2019

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Background: Autologous osteochondral transplantation (AOT) has been shown to be a viable treatment option for large osteochondral lesions of the talus. However, there are limited data regarding the management of large lesions in an athletic population, notably with regard to return to sport. Our investigation focused on assessing both qualitative and quantitative outcomes in the high-demand athlete with large (>150 mm2) lesions. Hypothesis: AOT is a viable option in athletes with large osteochondral lesions and can allow them to return to sport at their preinjury level. Study Design: Case series; Level of evidence, 4. Methods: The study population was limited to professional and amateur athletes (Tegner score, >6) with a talar osteochondral lesion size of 150 mm2 or greater. The surgical intervention was AOT with a donor site from the lateral femoral condyle. Clinical outcomes at a minimum of 24 months included return to sport, visual analog scale (VAS) for pain score, and Foot and Ankle Outcome Score (FAOS). In addition, graft incorporation was evaluated by magnetic resonance imaging (MRI) using MOCART (magnetic resonance observation of cartilage repair tissue) scores at 12 months after surgery. Results: A total of 38 athletes, including 11 professional athletes, were assessed. The mean follow-up was 45 months. The mean lesion size was 249 mm2. Thirty-three patients returned to sport at their previous level, 4 returned at a lower level compared with preinjury, and 1 did not return to sport (mean return to play, 8.2 months). The VAS improved from 4.53 preoperatively to 0.63 postoperatively ( P = .002). FAOSs improved significantly in all domains ( P < .001). Two patients developed knee donor site pain, and both had 3 osteochondral plugs harvested. Univariant analysis demonstrated no association between preoperative patient or lesion characteristics and ability to return to sport. However, there was a strong correlation between MOCART scores and ability to return to sport. The area under receiver operating characteristic of the MOCART score and return to play was 0.891 ( P = .005), with a MOCART score of 52.50 representing a sensitivity of 0.85 and specificity of 0.80 in determining ability to return to one’s previous level of activity. Conclusion: Our study suggests that AOT is a viable option in the management of large osteochondral talar defects in an athletic population, with favorable return to sport level, patient satisfaction, and FAOS/VAS scores. The ability to return to sport is predicated upon good graft incorporation, and further research is required to optimize this technique. Our data also suggest that patients should be aware of the increased risk of developing knee donor site pain when 3 osteochondral plugs are harvested.

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“…Therefore, an increasing number of scholars have proposed enhanced methods to augment MFx, such as collagen, hydrogels, bone marrow aspirate concentrate, polymerase chain reaction, hyaluronic acid, and MSCs. However, the efficacy and safety of MFx+ reported in previous articles are inconsistent (20,(53)(54)(55)(56)(57)(58). The reviews regarding MFx for talar cartilage defect repair are numerous (20,(59)(60)(61)(62), but few compare the efficacy and safety between MFx and MFx+.…”

Section: Mfx For Articular Cartilage Defectsmentioning

confidence: 99%

Augmented Microfracture Technique Versus Microfracture in Talar Cartilage Restoration: A Systematic Review and Meta-Analysis

Wen

Zhu

Tan³

et al. 2021

The Journal of Foot and Ankle Surgery

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Platelet-Rich Plasma and Concentrated Bone Marrow Aspirate in Surgical Treatment for Osteochondral Lesions of the Talus

Cited by 13 publications

References 63 publications

Osteochondral Lesions of the Talus: A Review on Talus Osteochondral Injuries, Including Osteochondritis Dissecans

Osteochondral Lesions of the Talus: A Review on Talus Osteochondral Injuries, Including Osteochondritis Dissecans

Autologous Osteochondral Transplantation for Large Osteochondral Lesions of the Talus Is a Viable Option in an Athletic Population

Augmented Microfracture Technique Versus Microfracture in Talar Cartilage Restoration: A Systematic Review and Meta-Analysis

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