Clinical outcome and T2 assessment following autologous matrix-induced chondrogenesis in osteochondral lesions of the talus.
OBJECTIVE
Scientific evidence for the treatment of osteochondral lesions (OCLs) of the talus is limited. The aim of this study was an evaluation of the clinical outcome after a one-step autologous subchondral cancellous bone graft and autologous matrix-induced chondrogenesis (AMIC) in medial OCLs of the talus and the assessment of the repair tissue (RT).


METHODS
Seventeen patients (eight women, nine men; mean age, 38.8 ± 15.7 years) with an OCL of the medial talus underwent surgery. Clinical and radiological assessment was performed after a mean follow-up of 39.5 ± 18.4 months, including established scoring systems (American Orthopaedic Foot and Ankle Society [AOFAS] Score, Foot Function Index [FFI], visual analogue scale [VAS]), evaluation of Magnetic Resonance Observation of Cartilage Repair Tissue scoring system (MOCART Score) and T2 mapping.


RESULTS
Preoperative pain (7.8 ± 2.1) significantly improved to an average of 3.2 ± 2.4 postoperatively. AOFAS Score averaged 82.6 ± 13.4, MOCART Score 52.7 ± 15.9. Mean T2 relaxation time of the RT was 41.6 ± 6.3 ms and showed no significant differences to the surrounding cartilage (mean, 38.8 ± 8.5; p = 0.58). MOCART Score significantly correlated with the AOFAS Score (rho = 0.574, p = 0.040). T2 relaxation time of the RT significantly correlated with the MOCART Score (rho = 0.593, p = 0.033).


CONCLUSIONS
The one-step autologous subchondral cancellous bone grafting and AMIC leads to a significant reduction in postoperative pain and satisfying postoperative functional outcome in mid-term follow-up. Magnetic resonance imaging (MRI) assessment demonstrated a good quality of regenerative tissue similar to the MRI ultrastructure of the surrounding cartilage.
Department of Surgery, Clinic for Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany. johanna.huebner@googlemail.com.
Eva Johanna
http://orcid.org/0000-0001-9460-3520
EJ
Kubosch
Department of Surgery, Clinic for Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany.
Benjamin
B
Erdle
Department of Surgery, Clinic for Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany.
Kaywan
K
Izadpanah
Department of Surgery, Clinic for Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany.
David
D
Kubosch
Department of Radiology, St. Josef's Hospital, Sautierstraße 1, 79104, Freiburg, Germany.
Markus
M
Uhl
Department of Surgery, Clinic for Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany.
Norbert P
NP
Südkamp
Department of Surgery, Clinic for Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany.
Philipp
P
Niemeyer
D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D002356:Cartilage / Q000601:surgery; D020219:Chondrogenesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D013628:Talus / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome; D064232:Visual Analog Scale; D014945:Wound Healing
Cartilage; MRI; Osteochondral lesion; T2 mapping; Talus