Clinical outcome and T2 assessment following autologous matrix-induced chondrogenesis in osteochondral lesions of the talus

Kubosch, Eva Johanna; Erdle, Benjamin; Izadpanah, Kaywan; Kubosch, David; Uhl, Markus; Südkamp, Norbert P.; Niemeyer, Philipp

doi:10.1007/s00264-015-2988-z

Cited by 75 publications

(72 citation statements)

References 26 publications

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“…However, the increase of MOCART score was not correlated with AOFAS score changes. Similarly to our results, Aurich et al did not find any correlation between MOCART and clinical scores after treatment with AMIC technique for OLTs [16] whereas, as we reported above, Kubosch et al found a significant correlation [14]. As suggested by Christensen and colleagues, a thorough radiological follow-up for patients with OLTs repaired using biomimetic scaffolds is recommended [8].…”

Section: Discussionsupporting

confidence: 87%

“…After a mean follow up of 39.5 ± 18.4 months, they also found a significant correlation between MOCART and AOFAS score [14]. In our study, MOCART score showed improvement of imaging findings after surgery.…”

Section: Discussionsupporting

confidence: 78%

“…Kubosch et al demonstrated a significant improvement in post-operative clinical and imaging findings in 17 patients with OLTs treated with autologous subchondral cancellous bone graft and AMIC [14]. After a mean follow up of 39.5 ± 18.4 months, they also found a significant correlation between MOCART and AOFAS score [14].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and imaging outcome of osteochondral lesions of the talus treated using autologous matrix-induced chondrogenesis technique with a biomimetic scaffold

Albano¹,

Martinelli²,

Bianchi³

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe purpose of our study was to assess the clinical and imaging outcome of autologous matrix-induced chondrogenesis (AMIC) technique consisting of microfractures followed by the filling of osteochondral lesions of the talus (OLTs) with a cell-free biphasic collagen-hydroxyapatite osteochondral scaffold (MaioRegen).MethodsSixteen patients (eight males, age: 42.6 ± 18.4, range 14–74) with OLT repaired using AMIC technique, with implantation of MaioRegen, were clinically evaluated through the American Orthopedic Foot and Ankle Society Score (AOFAS) and a 10-point Visual Analogue Scale (VAS) pain score after a mean follow-up of 30 ± 16.9 months. The MRI examinations were performed 12 and 24 months after surgery. A paired t-test was applied to compare pre- and post-operative clinical findings (VAS and AOFAS) and Magnetic resonance observation of cartilage repair tissue (MOCART) score changes in the follow-up. To assess the correlation between variation of AOFAS and MOCART scores, the Pearson’s correlation coefficient was calculated.ResultsNo complications after surgery were encountered. From pre-operative to post-operative values, there was a significant (P < 0.001) reduction of mean VAS pain score (6.3 ± 0.9,range: 4–8 and 2.9 ± 1.8,range: 0–6, respectively) and increase of AOFAS score (60.2 ± 7.8,range: 50–74 and 77.4 ± 16.2,range: 50–100, respectively). Among 16 patients, six (37%) were not satisfied at the end of follow-up, six (37%) were moderately satisfied and four (25%) were highly satisfied. The treatment was considered failed in five out of 16 patients (31%). Among them, four (25%) required re-interventions with implantation of ankle prostheses, whereas one patient was treated with a further AMIC technique combined with autologous bone graft and platelet-rich plasma. The mean MOCART score was 41.9 ± 14.6 (25–70) 12 months after surgery and 51.9 ± 11.6 (30–70) after 24 months, with a statistically significant increase (P = 0.012). However, no correlation was seen between AOFAS and MOCART changes (r = 0.215, p = 0.609).ConclusionThe high rates of treatment failure encountered in our study using MaioRegen need to be confirmed by larger studies and should induce the scientific community questioning the reliability of this biomimetic scaffold for the treatment of OLTs.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 78%

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Clinical and imaging outcome of osteochondral lesions of the talus treated using autologous matrix-induced chondrogenesis technique with a biomimetic scaffold

Albano¹,

Martinelli²,

Bianchi³

et al. 2017

BMC Musculoskelet Disord

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“…The most important of which reported significant improvement in functional outcomes and MOCART scores, which demonstrated a good quality repair tissue similar to the MRI ultrastructure of the surrounding cartilage at an average of 2 year follow-up. 52 Although this seems to be promising, several studies in the knee have shown inferior reparative response on MRI with incomplete or heterogeneous fill. 53,54 This raises the question of whether there is a sufficient concentration of the MSC niche in the AMIC membrane to support chondrogenesis and repair of critical-sized defects, with questionable long-term durability that might affect results.…”

Section: Autologous Matrix-induced Chondrogenesismentioning

confidence: 97%

Recent Advances in Egypt for Treatment of Talar Osteochondral Lesions

Haleem

Abousayed

Gomaa

2016

Foot and Ankle Clinics

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“…Despite AMIC showing good functional outcomes in the literature, most studies are small case series and, to our knowledge, no study has described the long-term outcomes. Kubosch et al [45] reported 17 patients following AMIC for medial OLT with a mean 39.5 months of follow-up and found that the mean postoperative AOFAS score was 82.6 and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was 52.7. MRI assessment demonstrated a good quality of regenerative tissue similar to the MRI ultrastructure of the surrounding cartilage.…”

Section: Autologous Matrix-induced Chondrogenesismentioning

confidence: 99%

Osteochondral lesions of the talus in the athlete: up to date review

Shimozono

Yasui

Ross

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of review Osteochondral lesions of the talus (OLT) are common injuries in athletes. The purpose of this study is to comprehensively review the clinical results and return to sport capacity in athletes following treatment for OLT. Recent findings Reparative procedures, such as bone marrow stimulation, and replacement procedures, such as autologous osteochondral transplantation, provide good clinical outcomes in short-and mid-term follow-up in the athlete. Recently, biological augmentation and scaffold-based therapies have been shown to improve clinical and radiological outcomes in OLT in both the general population and athletes. Summary Most studies are of a low level of evidence. Studies analyzing the return to sport capability in athletes are further lacking. High-level evidence and well-designed clinical trials are required to establish the most effective treatment protocol.

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Clinical outcome and T2 assessment following autologous matrix-induced chondrogenesis in osteochondral lesions of the talus

Cited by 75 publications

References 26 publications

Clinical and imaging outcome of osteochondral lesions of the talus treated using autologous matrix-induced chondrogenesis technique with a biomimetic scaffold

Clinical and imaging outcome of osteochondral lesions of the talus treated using autologous matrix-induced chondrogenesis technique with a biomimetic scaffold

Recent Advances in Egypt for Treatment of Talar Osteochondral Lesions

Osteochondral lesions of the talus in the athlete: up to date review

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