AMIC for Focal Osteochondral Defect of the Talar Shoulder

Abstract

Background: The management of a focal osteochondral lesion of the talus (OLT) is challenging. Evidence concerning the role of the autologous matrix-induced chondrogenesis (AMIC) procedure in patients with focal OLT is promising. The purpose of the present study was to investigate clinical outcomes and radiographic findings of the AMIC technique for focal unipolar OLT. Material and Methods: The present study was performed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Twenty-four patients who underwent AMIC for focal OLT were prospectively recruited at our institution. All the surgeries were performed by two experienced surgeons through malleolar osteotomy and autologous cancellous bone grafting. The outcomes of interest were the American orthopedic foot and ankle score (AOFAS), the foot-function index (FFI), and the magnetic resonance observation of cartilage repair tissue (MOCART). Surgical duration, hospitalization length, and complications were also collected. Results: 24 patients were included in the present study. The mean follow-up was 25.17 ± 13.1 months. The mean age of the patients at surgery was 46.75 ± 15.2 years, the mean BMI 26.92 ± 5.7 kg/m2, and 50% (12 of 24) of patients were female. The right ankle was involved in 62.5% (15 of 24) of patients. The mean defect size was 6.95 ± 2.9 mm2. The mean surgical duration was 112 ± 20 min while the mean hospitalization 5.58 ± 1.7 days. At last follow-up, the AOFAS increased by 27.8 points (p < 0.0001), while the FFI reduced by 25.3 points (p < 0.0001) and the MOCART score increased by 28.33 points (p < 0.0001). No complications were observed. Conclusion: The AMIC procedure for focal osteochondral defects of the talar shoulder is feasible and reliable at midterm follow-up.

Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study

“…Symptomatic chondral defects negatively affect the activities of daily life and sporting activity level [ 25 , 31 ]. The low metabolic activity of hyaline cartilage, along with its alymphatic and hypocellular structure, are some of the reasons behind its poor regenerative capabilities [ 3 , 4 , 5 ].…”

“…When an osteotomy was performed, it was fixed with two malleolar screws inserted through the predrilled holes and the wound sutured in a standard fashion. The rehabilitation protocol was performed according to that previously published [ 25 ].…”

“…Autologous Matrix-Induced Chondrogenesis (AMIC) has been recently introduced [ 2 , 24 ]. AMIC does not require a harvest site, cell expansion, and is performed in a single surgical session [ 25 , 26 ]. AMIC is combined with MFx covering the lesions with a resorbable membrane to stabilize the resulting blood clot [ 27 , 28 ].…”

“…AMIC is combined with MFx covering the lesions with a resorbable membrane to stabilize the resulting blood clot [ 27 , 28 ]. Thus, AMIC exploits the regenerative potential of bone marrow-derived mesenchymal stem cells arising from the subchondral bone [ 25 , 29 ].…”

Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial

“…Irrespective of the generation, ACI requires harvesting, external chondrocyte expansion, and a second stage surgery for re-implantation [13][14][15]. The superiority of ACI compared to MFx is still controversial [16][17][18]. Autologous Matrix-Induced Chondrogenesis (AMIC) avoids cartilage harvest and external expansion and is performed in a single surgical session [19,20].…”