Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions. (May 2017)

• Record Type: Journal Article
• Authors: D'Ambrosi, Riccardo; Maccario, Camilla; Ursino, Chiara; Serra, Nicola; Usuelli, Federico Giuseppe
• Is Part Of: Foot & ankle international. Volume 38:Number 5(2017:May)
• Page Start: 485
• Page End: 495
• Publication Date: 2017-05
• Subjects: juvenile osteochondral talar lesions -- quality of life -- autologous bone graft -- autologous matrix-induced chondrogenesis -- microfractures -- BMI; Foot -- Abnormalities -- Periodicals; Ankle -- Abnormalities -- Periodicals; Orthopedics -- Periodicals; 617.585
• DOI: 10.1177/1071100716687367
• Languages: English
• ISSNs: 1071-1007

Abstract

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0 ) and at 6 (T1 ), 12 (T2 ), and 24 (T3 ) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm 3 ± 0.5 cm 3 . We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3 . Lesion area significantly reduced from 119.1 ± 29.1 mm 2 preoperatively to 77.9 ± 15.8 mm 2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm 2 to 85.3 ± 14.5 mm 2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.