Functional Outcome of Matrix-Associated Autologous Chondrocyte Implantation in the Ankle

Dixon, Sean; Harvey, Leigh; Baddour, Edward; Janes, Gregory C.; Hardisty, Gerard

doi:10.3113/fai.2011.0368

Cited by 31 publications

(14 citation statements)

References 42 publications

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“…The weighted mean MCMS of the overall population of studies was 49.3 ± 10.0 out of a possible 100 points. There were seven studies (25%) of fair quality [ 8 , 18 , 20 , 21 , 30 , 31 , 38 ] and the remainder (75%) were of poor quality[ 4 - 7 , 16 , 17 , 19 , 22 - 29 , 32 - 37 ] (Table 5 ). Further QOE data is shown in Table 5 .…”

Section: Resultsmentioning

confidence: 99%

Scaffolds based therapy for osteochondral lesions of the talus: A systematic review

Shimozono

Yasui

Ross

et al. 2017

WJO

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AIMTo clarify the effectiveness of scaffold-based therapy for osteochondral lesions of the talus (OLT).METHODSA systematic search of MEDLINE and EMBASE databases was performed during August 2016 and updated in January 2017. Included studies were evaluated with regard to the level of evidence (LOE) and quality of evidence (QOE) using the Modified Coleman Methodology Score. Variable reporting outcome data, clinical outcomes, and the percentage of patients who returned to sport at previous level were also evaluated.RESULTSTwenty-eight studies for a total of 897 ankles were included; 96% were either LOE III or IV. Studies were designated as either of poor or fair quality. There were 30 treatment groups reporting six different scaffold repair techniques: 13 matrix-induced autologous chondrocyte transplantation (MACT), nine bone marrow derived cell transplantation (BMDCT), four autologous matrix-induced chondrogeneis (AMIC), and four studies of other techniques. The categories of general demographics (93%) and patient-reported outcome data (85%) were well reported. Study design (73%), imaging data (73%), clinical variables (49%), and patient history (30%) were also included. The weighted mean American Orthopaedic Foot and Ankle Society (AOFAS) score at final follow-up was: 86.7 in MACT, 88.2 in BMDCT, and 82.3 in AMIC. Eight studies reported that a weighted mean of 68.3% of patients returned to a previous level of sport activity.CONCLUSIONScaffold-based therapy for OLT may produce favorable clinical outcomes, but low LOE, poor QOE, and variability of the data have confounded the effectiveness of this treatment.

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Section: Resultsmentioning

confidence: 99%

Scaffolds based therapy for osteochondral lesions of the talus: A systematic review

Shimozono

Yasui

Ross

et al. 2017

WJO

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“…16,27,56 Different treatment modalities have also been described, such as microfracture, 7,18,44,50 osteochondral autograft 20,30,31 or allograft 1,25,40 transplantation, and matrix-induced chondrocyte implantation. 3,15,23 Microfracture is a simple, minimally invasive method that leads to recruitment of chondrogenic cells from the bone marrow, which results in the formation of fibrocartilage but does not achieve restoration of the subchondral osseous defect. By contrast, the key benefit of osteochondral autograft transplantation is that the osteochondral lesion is filled with a cylinder of hyaline cartilage and subchondral bone in a single-step procedure.…”

mentioning

confidence: 99%

Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A Clinical and Radiological 2- to 8-Year Follow-up Study

et al. 2019

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Background: Autologous matrix-induced chondrogenesis (AMIC) has become an interesting treatment option for osteochondral lesions of the talus (OLTs) with promising clinical short- to midterm results. Purpose: To investigate the clinical and radiological outcome of the AMIC procedure for OLTs, extending the follow-up to 8 years. Study Design: Case series; Level of evidence, 4. Methods: Thirty-three patients (mean age, 35.1 years; body mass index, 26.8) with osteochondral lesions of the medial talar dome were retrospectively evaluated after open AMIC repair at a mean follow-up of 4.7 years (range, 2.3-8.0 years). Patients requiring additional surgical procedures were excluded. All OLTs (mean size, 0.9 cm2; range, 0.4-2.3 cm2) were approached through a medial malleolar osteotomy, and 28 patients received subchondral autologous bone grafting. Data analysis included the visual analog scale for pain, the American Orthopaedic Foot and Ankle Society score for ankle function, the Tegner score for sports activity, and the MOCART (magnetic resonance observation of cartilage repair tissue) scoring system for repair cartilage and subchondral bone evaluation. Results: Mean ± SD visual analog scale score improved significantly from 6.4 ± 1.9 preoperatively to 1.4 ± 2.0 at latest follow-up ( P < .001). The mean American Orthopaedic Foot and Ankle Society score was 93.0 ± 7.5 (range, 75-100). The Tegner score improved significantly from 3.5 ± 1.8 preoperatively to 5.2 ± 1.7 at latest follow-up ( P < .001), and 79% returned to their previous sports levels. The MOCART score averaged 60.6 ± 21.2 (range, 0-100). Complete filling of the defect was seen in 88% of cases, but 52% showed hypertrophy of the cartilage layer. All but 1 patient showed persistent subchondral bone edema. The patient’s age and body mass index, the size of the osteochondral lesion, and the MOCART score did not show significant correlation with the clinical outcome. There were no cases of revision surgery for failed AMIC. Fifty-eight percent underwent reoperation, mainly for symptomatic hardware after malleolar osteotomy. Conclusion: AMIC for osteochondral talar lesions led to significant pain reduction, recovery of ankle function, and successful return to sport. The MOCART score did not correlate with the good clinical results; the interpretation of postoperative imaging remains therefore challenging.

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“…Dixon et al (25) No 28 13 Aurich et al (20) Sí 19 24,5 5,3% mejora escala clínica Magnan et al (21) No 30 45 AOFAS mejora 36,9 a 83,9…”

Section: Tabla 2 Resumen De Los Resultados De Estudios Con Técnica Munclassified

“…Respecto a la técnica MACI, de nuevo nos encontramos con series de casos y faltan trabajos que comparen otras opciones de manejo quirúrgico (11,(20)(21)(22)(23)(24)(25)(26) .…”

Section: Técnica Maciunclassified

Aci/Maci

Torrente¹

2017

MACT

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Functional Outcome of Matrix-Associated Autologous Chondrocyte Implantation in the Ankle

Abstract: Careful preoperative counseling is required for patients of all ages regarding likely outcomes. In patients over 40, the procedure is unlikely to give good pain relief and alternative options should be considered.

Cited by 31 publications

References 42 publications

Scaffolds based therapy for osteochondral lesions of the talus: A systematic review

Scaffolds based therapy for osteochondral lesions of the talus: A systematic review

Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A Clinical and Radiological 2- to 8-Year Follow-up Study

Aci/Maci

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