title: The use of fibrin matrix-mixed gel-type autologous chondrocyte implantation in the treatment for osteochondral lesions of the talus.
abstract: OBJECTIVE
  This study assessed the clinical results and second-look arthroscopy after fibrin matrix-mixed gel-type autologous chondrocyte implantation to treat osteochondral lesions of the talus.
  
  
  METHODS
  Chondrocytes were harvested from the cuboid surface of the calcaneus in 38 patients and cultured, and gel-type autologous chondrocyte implantation was performed with or without medial malleolar osteotomy. Preoperative American orthopedic foot and ankle society ankle-hind foot scores, visual analogue score, Hannover scoring system and subjective satisfaction were investigated, and the comparison of arthroscopic results (36/38, 94.7 %) and MRI investigation of chondral recovery was performed. Direct tenderness and relationship to the active daily life of the donor site was evaluated.
  
  
  RESULTS
  The preoperative mean ankle-hind foot scores (71 ± 14) and Hannover scoring system (65 ± 10) had increased to 91 ± 12 and 93 ± 14, respectively, at 24-month follow-up (p < 0.0001), and the preoperative visual analogue score of 58 mm had decreased to 21 mm (p < 0.0001). Regarding subjective satisfaction, 34 cases (89.5 %) reported excellent, good or fair. Chondral regeneration was analysed by second-look arthroscopy and MRI. Complications included one non-union and two delayed-unions of the osteotomy sites, and 9 ankles (9/31, 29.0 %) sustained damaged medial malleolar cartilage due to osteotomy. Marked symptoms at the biopsy site did not adversely affect the patient's active daily life.
  
  
  CONCLUSIONS
  Fibrin matrix-mixed gel-type autologous chondrocyte implantation using the cuboid surface of the calcaneus as a donor can be used for treating osteochondral lesions of the talus.
authors: Foot and Ankle Clinic, KT Lee's Orthopedic Hospital, Seoul, Korea.
authors: Kyung Tai
authors: KT
authors: Lee
authors: Jin Su
authors: JS
authors: Kim
authors: Ki Won
authors: KW
authors: Young
authors: Young Koo
authors: YK
authors: Lee
authors: Young Uk
authors: YU
authors: Park
authors: Yong Hoon
authors: YH
authors: Kim
authors: Hun Ki
authors: HK
authors: Cho
mesh_terms: D000328:Adult; D001182:Arthroscopy; D002111:Calcaneus / Q000601:surgery; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation*; D003646:Debridement; D005260:Female; D005337:Fibrin / Q000008:administration & dosage; D050723:Fractures, Bone / Q000601:surgery*; D005782:Gels / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D013628:Talus / Q000293:injuries / Q000601:surgery*; D013917:Thrombin / Q000008:administration & dosage; D014182:Transplantation, Autologous / Q000379:methods; D055815:Young Adult
chemical_list: D005782:Gels; D005337:Fibrin; D013917:Thrombin