Functional Medium-Term Results After Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A 5-Year Prospective Cohort Study
Oliver Gottschalk, Sebastian Altenberger, Sebastian Baumbach, Stefanie Kriegelstein, Florian Dreyer, Alexander Mehlhorn, Hubert Hörterer, Andreas Toepfer, Anke Röser & Markus Walther
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abstract
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Autologous matrix-induced chondrogenesis (AMIC) has gained
popularity in the treatment of osteochondral lesions of the talus.
Previous studies have presented promising short-term results for
AMIC talar osteochondral lesion repair, a 1-step technique using a
collagen type I/III bilayer matrix. The aim of the present study was
to investigate the mid-term effects. The 5-year results of a
prospective cohort study are presented. All patients underwent an
open AMIC procedure for a talar osteochondral lesion. Data analysis
included general demographic data, preoperative magnetic resonance
imaging findings, intraoperative details, and German version of the
Foot Function Index (FFI-D) scores preoperatively and at 1 and
5 years after surgery. The primary outcome variable was the
longitudinal effect of the procedure, and the influence of various
variables on the outcome was tested. Of 47 consecutive patients, 21
(45%) were included. Of the 21 patients, 8 were female (38%) and 13
were male (62%), with a mean age of
37 ± 15 (range 15 to 62) years and a body
mass index of 26 ± 5 (range 20 to
38) kg/m. The defect size was 1.4 ± 0.9 (range 0.2
to 4.0) cm. The FFI-D decreased significantly from
preoperatively to 1 year postoperatively (56 ± 18
versus 33 ± 25; p = .003), with a
further, nonsignificant decrease between the 1- and 5-year follow-up
examination (33 ± 25 versus
24 ± 21; p = .457). Similar results were
found for the FFI-D subscales of function and pain. The body mass
index and lesion size showed a positive correlation with the
preoperative FFI-D overall and subscale scores. These results showed
a significant improvement in pain and function after the AMIC
procedure, with a significant return to sports by the 5-year
follow-up point. The greatest improvement overall was seen within
the first year; however, further clinical satisfaction among the
patients was noticeable after 5 years.
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citation
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Gottschalk O, Altenberger S, Baumbach S, Kriegelstein S, Dreyer F,
Mehlhorn A, Hörterer H, Toepfer A, Röser A, Walther M. Functional
Medium-Term Results After Autologous Matrix-Induced Chondrogenesis
for Osteochondral Lesions of the Talus: A 5-Year Prospective Cohort
Study. J Foot Ankle Surg 2017; 56:930-936.
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type
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journal paper/review (English)
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date of publishing
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21-06-2017
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journal title
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J Foot Ankle Surg (56/5)
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ISSN electronic
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1542-2224
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pages
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930-936
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PubMed
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28647522
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DOI
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10.1053/j.jfas.2017.05.002
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