Comparison of Juvenile Allogenous Articular Cartilage and Bone Marrow Aspirate Concentrate Versus Microfracture With and Without Bone Marrow Aspirate Concentrate in Arthroscopic Treatment of Talar Osteochondral Lesions

Karnovsky, Sydney C.; DeSandis, Bridget; Haleem, Amgad M.; Sofka, Carolyn M.; O’Malley, Martin J.; Drakos, Mark C.

doi:10.1177/1071100717746627

Cited by 45 publications

(45 citation statements)

References 75 publications

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“… a RTS, return to sports. b References 6, 15, 17, 18, 20, 26, 29, 35, 38, 41, 43, 47, 54, 58 –60, 69, 75, 76, 85, 88, 92, 94. c Range of means of original data.…”

Section: Resultsmentioning

confidence: 99%

“…A variety of outcome measures were reported within this group. The FAOS sports score was reported by 2 studies, 35,54 1 study reported on the Foot and Ankle Disability Index (FADI) sports subscale, 8 and 1 study reported on the German Foot Function Index (FFI-D) sports subscale. 25 Because of low reporting, these scores were not further analyzed.…”

Section: Resultsmentioning

confidence: 99%

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Return to Sports After Surgical Treatment of Osteochondral Defects of the Talus: A Systematic Review of 2347 Cases

Steman

Dahmen

Lambers

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: Osteochondral defects (OCDs) of the talus are found subsequent to ankle sprains and ankle fractures. With many surgical treatment strategies available, there is no clear evidence on return-to-sport (RTS) times and rates. Purpose: To summarize RTS times and rates for talar OCDs treated by different surgical techniques. Study Design: Systematic review; Level of evidence, 4. Methods: The literature from January 1996 to November 2018 was screened, and identified studies were divided into 7 different surgical treatment groups. The RTS rate, with and without associated levels of activity, and the mean time to RTS were calculated per study. When methodologically possible, a simplified pooling method was used to combine studies within 1 treatment group. Study bias was assessed using the MINORS (Methodological Index for Non-Randomized Studies) scoring system. Results: A total of 61 studies including 2347 talar OCDs were included. The methodological quality of the studies was poor. There were 10 retrospective case series (RCSs) that investigated bone marrow stimulation in 339 patients, with a pooled mean rate of RTS at any level of 88% (95% CI, 84%-91%); 2 RCSs investigating internal fixation in 47 patients found a pooled RTS rate of 97% (95% CI, 85%-99%), 5 RCSs in which autograft transplantation was performed in 194 patients found a pooled RTS rate of 90% (95% CI, 86%-94%), and 3 prospective case series on autologous chondrocyte implantation in 39 patients found a pooled RTS rate of 87% (95% CI, 73%-94%). The rate of return to preinjury level of sports was 79% (95% CI, 70%-85%) for 120 patients after bone marrow stimulation, 72% (95% CI, 60%-83%) for 67 patients after autograft transplantation, and 69% (95% CI, 54%-81%) for 39 patients after autologous chondrocyte implantation. The mean time to RTS ranged from 13 to 26 weeks, although no pooling was possible for this outcome measure. Conclusion: Different surgical treatment options for talar OCDs allow for adequate RTS times and rates. RTS rates decreased when considering patients’ return to preinjury levels versus return at any level.

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“… a RTS, return to sports. b References 6, 15, 17, 18, 20, 26, 29, 35, 38, 41, 43, 47, 54, 58 –60, 69, 75, 76, 85, 88, 92, 94. c Range of means of original data.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Return to Sports After Surgical Treatment of Osteochondral Defects of the Talus: A Systematic Review of 2347 Cases

Steman

Dahmen

Lambers

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…A recent study comparing DeNovo NT and microfracture in talar osteochondral defects found no differences in patient-reported outcomes or repair tissue quality. 67…”

Section: Methodsmentioning

confidence: 99%

Beyond Cartilage Repair: The Role of the Osteochondral Unit in Joint Health and Disease

Lepage

Robson

Gilmore

et al. 2019

Tissue Engineering Part B: Reviews

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Once believed to be limited to articular cartilage, osteoarthritis is now considered to be an organ disease of the “whole joint.” Damage to the articular surface can lead to, be caused by, or occur in parallel with, damage to other tissues in the joint. The relationship between cartilage and the underlying subchondral bone has particular importance when assessing joint health and determining treatment strategies. The articular cartilage is anchored to the subchondral bone through an interface of calcified cartilage, which as a whole makes up the osteochondral unit. This unit functions primarily by transferring load-bearing weight over the joint to allow for normal joint articulation and movement. Unfortunately, irreversible damage and degeneration of the osteochondral unit can severely limit joint function. Our understanding of joint pain, the primary complaint of patients, is poorly understood and past efforts toward structural cartilage restoration have often not been associated with a reduction in pain. Continued research focusing on the contribution of subchondral bone and restoration of the entire osteochondral unit are therefore needed, with the hope that this will lead to curative, and not merely palliative, treatment options. The purpose of this narrative review is to investigate the role of the osteochondral unit in joint health and disease. Topics of discussion include the crosstalk between cartilage and bone, the efficacy of diagnostic procedures, the origins of joint pain, current and emerging treatment paradigms, and suitable preclinical animal models for safety and efficacy assessment of novel osteochondral therapies. The goal of the review is to facilitate an appreciation of the important role played by the subchondral bone in joint pain and why the osteochondral unit as a whole should be considered in many cases of joint restoration strategies. Impact Statement In this comprehensive review, we are providing a holistic overview of osteochondral tissue development, disease, pain localization, as well as structural evaluation and current repair strategies. This review is intended to serve as a broad introduction to this multidisciplinary research area. It is a thorough examination of the biological aspects of the osteochondral unit from a tissue engineering perspective, highlighting the importance of the subchondral bone in chondral and osteochondral lesion repair and pain relief.

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“…However, no differences were observed between placebo and treated knee 6 months after treatment [60] and 12 months after treatment [61]. Two studies were designed to treat osteochondral lesions of the talus, both used juvenile allogenic chondrocyte implantation (JACI) and BMAC [62,63]. The first study compared the pre- to postoperatively outcomes [62].…”

Section: Bone Marrow Aspirate Concentrate (Bmac)mentioning

confidence: 99%

“…Unfortunately, this study did not quantify the cells and did not mention the system used to prepare the BMAC. In the second study, the authors used the Magellan system to produce the BMAC, however they did not quantify the number of progenitor cells [63]. The authors compared the microfracture (MF) with JACI–BMAC.…”

Section: Bone Marrow Aspirate Concentrate (Bmac)mentioning

confidence: 99%

PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers

Yamaguchi

Shams

Silva

et al. 2019

IJMS

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Platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) are orthobiologic therapies considered as an alternative to the current therapies for muscle, bone and cartilage. Different formulations of biomaterials have been used as carriers for PRP and BMAC in order to increase regenerative processes. The most common biomaterials utilized in conjunction with PRP and BMAC clinical trials are organic scaffolds and natural or synthetic polymers. This review will cover the combinatorial strategies of biomaterial carriers with PRP and BMAC for musculoskeletal conditions (MsCs) repair and regeneration in clinical trials. The main objective is to review the therapeutic use of PRP and BMAC as a treatment option for muscle, bone and cartilage injuries.

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Comparison of Juvenile Allogenous Articular Cartilage and Bone Marrow Aspirate Concentrate Versus Microfracture With and Without Bone Marrow Aspirate Concentrate in Arthroscopic Treatment of Talar Osteochondral Lesions

Abstract: Level III, comparative series.

Cited by 45 publications

References 75 publications

Return to Sports After Surgical Treatment of Osteochondral Defects of the Talus: A Systematic Review of 2347 Cases

Return to Sports After Surgical Treatment of Osteochondral Defects of the Talus: A Systematic Review of 2347 Cases

Beyond Cartilage Repair: The Role of the Osteochondral Unit in Joint Health and Disease

PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers

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