title: Regenerative treatment in osteochondral lesions of the talus: autologous chondrocyte implantation versus one-step bone marrow derived cells transplantation.
abstract: OBJECTIVE
  Osteochondral lesions of the talus (OLT) usually require surgical treatment. Regenerative techniques for hyaline cartilage restoration, like autologous chondrocytes implantation (ACI) or bone marrow derived cells transplantation (BMDCT), should be preferred. The aim of this work is comparing two clusters with OLT, treated with ACI or BMDCT.
  
  
  METHODS
  Eighty patients were treated with regenerative techniques, 40 with ACI and 40 with BMDCT. The two groups were homogenous regarding age, lesion size and depth, previous surgeries, etiology of the lesion, subchondral bone graft, final follow-up and pre-operative AOFAS score. The two procedures were performed arthroscopically. The scaffold was a hyaluronic acid membrane in all the cases, loaded with previously cultured chondrocytes (ACI) or with bone marrow concentrated cells, harvested in the same surgical session (BMDCT). All the patients were clinically and radiologically evaluated, using MRI Mocart score and T2 mapping sequence.
  
  
  RESULTS
  Clinical results were similar in both groups at 48 months. No statistically significant influence was reported after evaluation of all the pre-operative parameters. The rate of return to sport activity showed slightly better results for BMDCT than ACI. MRI Mocart score was similar in both groups. MRI T2 mapping evaluation highlighted a higher presence of hyaline like values in the BMDCT group, and lower incidence of fibrocartilage as well.
  
  
  CONCLUSIONS
  To date, ACI and BMDCT showed to be effective regenerative techniques for the treatment of OLT. BMDCT could be preferred over ACI for the single step procedure, patients' discomfort and lower costs.
authors: Orthopaedics and Traumatology, I Clinic, Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy.
authors: Roberto
authors: R
authors: Buda
authors: Francesca
authors: F
authors: Vannini
authors: Francesco
authors: F
authors: Castagnini
authors: Marco
authors: M
authors: Cavallo
authors: Alberto
authors: A
authors: Ruffilli
authors: Laura
authors: L
authors: Ramponi
authors: Gherardo
authors: G
authors: Pagliazzi
authors: Sandro
authors: S
authors: Giannini
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation / Q000379:methods*; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D051457:Hyaline Cartilage; D006820:Hyaluronic Acid; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013628:Talus / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D006820:Hyaluronic Acid