Matrix-Induced Autologous Chondrocyte Implantation (MACI) grafting for osteochondral lesions of the talus.
BACKGROUND
Articular cartilage is limited in its ability to repair itself. Matrix-induced Autologous Chondrocyte Implantation (MACI) is an established treatment method for such articular cartilage defects in the knee. Recently the technique has been used in the ankle. We present a series of patients treated with MACI for osteochondral defects of the ankle, and assess the functional and clinical results.


METHODS
From August 2003 to February 2006, 20 patients underwent MACI grafting for osteochondral defects in the ankle. Age ranged from 19 to 61 (mean, 36) years. Mean followup was 21.1 months. Clinical and functional evaluations were conducted using the AOFAS scoring system.


RESULTS
The mean size was 233 mm(2). There was a significant improvement in mean AOFAS score from 60 (range, 25 to 87) to 87 (range, 41 to 100) (p < 0.0001). Overall improvement in pain scores was also significant (p < 0.0001). All osteotomies healed. Four patients required hardware removal and two underwent arthroscopic debridement for anterior impingement. There were two failures which are awaiting subsequent procedures.


CONCLUSIONS
We believe MACI is a reliable treatment method for talar osteochondral defects. The method usually requires an intra-articular osteotomy, although this proved to be a reasonably simple aspect of the procedure for the treatment of cartilage defects of the talus.
Schneider
Timothy E
TE
Melbourne Orthopaedic Group, Windsor, Victoria, Australia. taschneider@mog.com.au
Karaikudi
Sriram
S
D000328:Adult; D000843:Ankle Joint; D001182:Arthroscopy; D019902:Chondrocytes / Q000637:transplantation*; D015331:Cohort Studies; D005260:Female; D024022:Fibrillar Collagens / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy; D012189:Retrospective Studies; D013628:Talus / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
D024022:Fibrillar Collagens