Document Detail


Arthroscopic treatment of osteochondral lesions of the ankle with matrix-associated chondrocyte implantation: early clinical and magnetic resonance imaging results.
MedLine Citation:
PMID:  21068444     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Conventional autologous chondrocyte transplantation in the ankle often requires tibial or fibular osteotomies with potential morbidity for the patient. Advances in biotechnology and surgical techniques have resulted in the development of matrix-associated chondrocyte implantation (MACI). As the chondrocyte-loaded scaffold can be applied arthroscopically, this procedure is especially useful for the treatment of osteochondral defects in the ankle.
HYPOTHESIS: Arthroscopic MACI is a safe procedure in the ankle with good clinical and magnetic resonance imaging results.
STUDY DESIGN: Case series; Level of evidence, 4.
METHODS: The authors reviewed all patients (n = 18) who had arthroscopic MACI for osteochondral lesions of the ankle (n = 19) between February 2006 and May 2008 clinically and with magnetic resonance imaging. The pain and disability module of the Foot Function Index (FFI), the American Orthopaedic Foot & Ankle Society (AOFAS) clinical rating system, the Core Scale of the Foot and Ankle Module of the American Academy of Orthopaedic Surgeons (AAOS) Lower Limb Outcomes Assessment Instruments, and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score were used. The clinical results up to 3 years after MACI (mean follow-up, 24.5 months) were compared with preoperative data for 14 cases and the magnetic resonance imaging data for all 19.
RESULTS: A significant improvement (50.3% ± 13.2%) in all clinical scores was noted (FFI pain before MACI: 5.5 ± 2.0, after MACI: 2.8 ± 2.2; FFI disability before MACI: 5.0 ± 2.3, after MACI: 2.6 ± 2.2; AOFAS before MACI: 58.6 ± 16.1, after MACI: 80.4 ± 14.1; AAOS standardized mean before MACI: 59.9 ± 16.0, after MACI: 83.5 ± 13.2; AAOS normative score before MACI: 23.0 ± 13.0, after MACI: 42.2 ± 10.7). According to the AOFAS Hindfoot score, 64% were rated as excellent and good, whereas 36% were rated fair and poor. The results correlated with the age of the patient and the duration of symptoms, but not with the size of the lesion. Sixteen patients (89%) reported regular sports activities before the onset of symptoms; 13 of them (81%) returned to sports after the MACI, 56% (n = 9) to the same level. The mean MOCART score was 62.4 ± 15.8 points. In general, there was no relation between MOCART score and clinical outcome, although the filling of the defect showed some correlation with the AAOS score.
CONCLUSION: Arthroscopic MACI is a safe procedure for the treatment of osteochondral lesions in the ankle with overall good clinical and magnetic resonance imaging results.
Authors:
Matthias Aurich; Harvinder S Bedi; Peter J Smith; Bernd Rolauffs; Thomas Mückley; James Clayton; Mark Blackney
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Publication Detail:
Type:  Journal Article     Date:  2010-11-10
Journal Detail:
Title:  The American journal of sports medicine     Volume:  39     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-08     Completed Date:  2011-06-23     Revised Date:  2012-12-07    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-9     Citation Subset:  IM    
Affiliation:
Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital, Erlanger Allee 101, 07740 Jena, Germany. matthias.aurich@med.uni-jena.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Ankle / pathology*,  surgery
Arthroscopy / methods*
Chondrocytes / transplantation*
Female
Humans
Magnetic Resonance Imaging*
Male
Middle Aged
Osteochondritis / pathology,  surgery*
Transplantation, Autologous
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Unfallchirurg. 2012 Oct;115(10):860   [PMID:  23052638 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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