Autologous Chondrocyte Implantation of the Ankle

Nam, Ellis K.; Ferkel, Richard D.; Applegate, Gregory R.

doi:10.1177/0363546508325670

Cited by 131 publications

(90 citation statements)

References 67 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)

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“…[16][17][18] However, Nam et al 18 did not recommend autologous chondrocyte implantation as an initial treatment option because the investigations on talar lesions were preliminary. Giza et al 17 suggested that matrix-induced autologous chondrocyte implantation into articular defects of the talus is a reasonable revision treatment for osteochondral defects of the talus in patients who do not respond to an initial bone marrow stimulation technique.…”

Section: Discussionmentioning

confidence: 99%

The “Cup-Shaped” Technique for Uncontained Osteochondral Lesion of the Talus

Yoshimura

Hagio

Naito

2013

Arthroscopy Techniques

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The arthroscopic bone marrow stimulation technique is defined as the first-line procedure for an osteochondral lesion of the talus. The containment of the lesion has been reported as 1 of the prognostic factors for clinical outcomes of arthroscopic bone marrow stimulation. It was surmised that lesions without a stable rim lose the protective border, thereby making stable formation of fibrocartilage less likely. The purpose of the cup-shaped technique is to improve the stability of blood clots after arthroscopic bone marrow stimulation in an uncontained lesion. The geometry of the lesion changes from "uncontained" to "contained like," which improves the stability of the blood clots.

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“…At followup 7 years after his injury, the patient had a normal physical examination and excellent functional outcome scores using the AOFAS Ankle-Hindfoot, Ankle Activity, and Tegner Activity Level Scales. Although the Tegner Activity Level Scale initially was designed for outcomes assessment of patients with knee ligament injuries, it has been used to assess function after ankle injuries as well [13,14,17,28]. The score of 100 was the maximal for the AOFAS AnkleHindfoot Scale; the score of 8 on the Ankle Activity Score represents tennis at the ''top level -international elite, professional, national team, or first division'' [8]; and level 8 on the Tegner Activity Level Scale represents ''competitive sports such as racquetball or bandy, squash or badminton, track and field athletics, downhill skiing'' [26].…”

Section: Discussionmentioning

confidence: 99%

Nonoperative Treatment of an Os Peroneum Fracture in a High-level Athlete: A Case Report

Smith

Johnson

Heckman

2011

Clinical Orthopaedics &Amp; Related Research

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Background The os peroneum is a sesamoid bone in the peroneus longus tendon. Fractures of the os peroneum are rare. Some authors recommend surgery for active patients. Case Description A 41-year-old male professional tennis coach sustained a minimally displaced fracture of the os peroneum. He was treated with restricted weightbearing for 2 weeks, followed by physical therapy and gradual return to activities. He returned to tennis 8 weeks after injury. Followup 7 years after the injury showed he had full strength, full motion, and a radiographically healed os peroneum.

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Autologous Chondrocyte Implantation of the Ankle

Abstract: Autologous chondrocyte implantation of the talus yields significant functional improvement; however, further investigation is necessary to determine the long-term structural and biomechanical properties of the repair tissue.

Cited by 131 publications

References 67 publications

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

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

The “Cup-Shaped” Technique for Uncontained Osteochondral Lesion of the Talus

Nonoperative Treatment of an Os Peroneum Fracture in a High-level Athlete: A Case Report

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