Clinical and Magnetic Resonance Imaging Outcomes of Microfracture Plus Chitosan/Blood Implant vs Microfracture for Osteochondral Lesions of the Talus

Abstract

Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 ( P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups ( P = .257 and .242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study.

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

“… a Significantly different from osteo(chondral) autograft transplantation therapies ( Q = 7.55, P = 0.0060) and metal implants ( Q = 5.27, P = 0.0217). 43,52,59,61 -63,66,81,92,93,109,113,117,121,123,125,131,135,141,143,146,149,150,153,158,164,165,167,168,171,173,176,177,179 -183,187,190,192,195 -200,202,204 -206 b Significantly different from metal implants ( Q = 3.86, P = 0.0493). 11,42,53,56,59,116,118,137,170,…”

Limited evidence of adjuvant biologics with bone marrow stimulation for the treatment of osteochondral lesion of the talus: a systematic review

“…This resulted in 13 studies that met the eligibility criteria and therefore, included in the systematic review (Fig. 1) [1, 2, 6, 8, 12, 14, 15, 19–21, 26, 27, 31]. The interobserver agreement rate of the included studies was 100%.…”

“…Comparative clinical studies with unique treatment arms were distinct in four studies [2, 6, 21, 27]. The studies investigated BMS versus AMIC [2], BMS versus BMS + chitosan‐glycerol phosphate/blood implant [6], BMS versus BMS + atelocollagen [21], and BMS versus CBMA alone [27]. The total number of OLTs as protocol of all treatment arms was 178.…”

What’s New in Foot and Ankle Surgery

“…There was no difference in patient-reported outcomes, but MRI scores using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scale were significantly higher in the biologic repair group. Camurcu et al 41 found near-identical negative clinical results in a similar retrospective comparison of microfracture alone and microfracture plus chitosan-glycerol phosphate mixed with peripheral blood. Park et al 42 found only modest degradation in patient-reported outcomes at the 10-year mark in a group of 189 patients who initially responded to microfracture.…”