Regenerative treatment in osteochondral lesions of the talus: autologous chondrocyte implantation versus one-step bone marrow derived cells transplantation

Buda, Roberto; Vannini, Francesca; Castagnini, Francesco; Cavallo, Marco; Ruffilli, Alberto; Ramponi, Laura; Pagliazzi, Gherardo; Giannini, Sandro

doi:10.1007/s00264-015-2685-y

Cited by 77 publications

(94 citation statements)

References 26 publications

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“…At the final follow-up, 72.8% were able to resume sports at preinjury level. Buda et al [52] compared clinical outcomes of two clusters of patients who underwent ACI or BMDCT for OLT and demonstrated that clinical results were similar in both groups at 48 months of follow-up. The rate of return to sports activity showed slightly better results for BMDCT compared to ACI; however, the difference was not statistically significant.…”

Section: Bone Marrow-derived Cell Transplantationmentioning

confidence: 99%

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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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Section: Bone Marrow-derived Cell Transplantationmentioning

confidence: 99%

“…Several clinical studies have shown that clinical outcomes improved using this procedure [49][50][51][52][53]54•]. Giannini et al [53] evaluated patients who underwent BMDCT and demonstrated improved AOFAS scores from 63.7 to 82.2 in 49 patients at a mean follow-up of 48 months.…”

Section: Bone Marrow-derived Cell Transplantationmentioning

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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“…1,11,[14][15][16] Previously published series showed encouraging results on general population; still no exhaustive articles report the results of this technique on the athletes and its impact on the return to sports. 1,11,[14][15][16] The aim of this study was to evaluate the return to sport of athletes with OLT, treated with one-step BMDCT procedure.…”

Section: Introductionmentioning

confidence: 99%

“…11 Nevertheless, microfractures restore a fibrocartilage tissue; whereas other techniques like autologous chondrocyte implantation (ACI) or bone marrow-derived cell transplantation (BMDCT) regenerate good quality hyaline cartilage. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] These techniques imply a longer rehabilitation (12 months): moreover, ACI requires high costs and 2 operations.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] Overtime various surgical options have been proposed to restore an adequate cartilaginous layer on the talar dome and overall good results were reported, but only few works have definitively focused on sportsmen. [3][4][5] The ideal treatment for cartilage lesions in the athlete is controversial: an early return to sport is crucial, but a resilient, qualitative osteochondral tissue is required as well.…”

Section: Introductionmentioning

confidence: 99%

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Return to Sports After Bone Marrow–Derived Cell Transplantation for Osteochondral Lesions of the Talus

et al. 2016

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Objective. Arthroscopic "one-step" technique based on bone marrow-derived cell transplantation (BMDCT) have achieved good results in repairing osteochondral lesions of the talus (OLT), overcoming important drawbacks of older techniques. It may be particularly adequate for the treatment of athletes in order to permit a safe and stable return to sports. The aim of this study was to report the results at 48 months of a series of athletes and the factors influencing the return to sports. Design. Case series. A total of 140 athletes underwent a "one-step" BMDCT repair of OLT. All the patients had the cells harvested from the iliac crest, condensed and loaded on a scaffold, and then implanted. Patients were evaluated clinically by the American Orthopaedic Foot and Ankle Society (AOFAS) scores and Halasi score. Results. AOFAS score improved from 58.7 ± 13.5 preoperatively to 90.6 ± 8.6 (P < 0.005) at 24 months, and to 90.9 ± 10.7 at 48 months. Halasi score was 6.88 ± 1.8 preinjury, 4.08 ± 1.7 preoperatively, and 5.56 ± 2.0 at final follow-up. At the final follow-up, all the patients (beside 1 failure and 3 lost) were able to return to activity and 72.8% were able to resume sports at preinjury level.Conclusions. "One-step" BMDCT repair of OLT had good clinical results that was durable over time in athletes, permitting a return to sports at preinjury level in the majority of patients. The preoperative presence of impingement and articular degeneration were the main negative prognostic factors.

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