title: Osteochondral Lesions of the Talus and Autologous Matrix-Induced Chondrogenesis: Is Age a Negative Predictor Outcome?
abstract: OBJECTIVE
  To assess and evaluate healing and functional outcomes after arthroscopic talus autologous matrix-induced chondrogenesis (AT-AMIC) in 2 age groups: patients older than 33 years versus patients 33 years or younger.
  
  
  METHODS
  A total of 31 patients, of whom 17 were 33 years or younger (G1) and 14 older than 33 years (G2), were evaluated. All patients were treated with AT-AMIC repair for osteochondral talar lesion. Magnetic resonance imaging (MRI) and computed tomography (CT)-scan evaluations, as well as clinical evaluations measured by the visual analog scale (VAS) score for pain, American Orthopaedic Foot and Ankle Society Ankle and Hindfoot score (AOFAS), and Short Form-12, were performed preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively.
  
  
  RESULTS
  G1consisted of 17 patients (mean age: 25 years, standard deviation: ±5), whereas G2consisted of 14 patients (mean age: 47 years, standard deviation: ±9). In both groups, we found a significant difference for clinical and radiological parameters with the analysis of variance for repeated measures through 4 time points (P < .001). In G1, AOFAS improved significantly between T0and T1(P = .025) and T1and T2(P = .011); CT showed a significant decrease between T1and T2(P = .003) and T2and T3(P < .0001), whereas MRI reduced significantly at each follow-up. In G2, AOFAS improved between T0and T1(P = .011) and T2and T3(P = .018); CT decreased between T1and T2(P = .025), whereas MRI showed a reduction between T1and T2(P = .029) and T2and T3(P = .006). AOFAS in G1was significantly higher at T0(P = .017), T2(P = .036), and T3(P = .039) compared with G2. A negative linear correlation between AOFAS and VAS at T1(R = -0.756), T2(R = -0.637), and T3(R = -0.728) was found in G1, whereas in G2, AOFAS was negatively correlated with VAS at T1(R = -0.702).
  
  
  CONCLUSIONS
  The study revealed that osteochondral lesions of the talus were characterized by similar sizes and features, both in young and old patients. We conclude that AT-AMIC can be considered a safe and reliable procedure that allows effective healing, regardless of age, with a significant clinical improvement; in particular, clinical results are related to starting conditions of the ankle.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy; Chirurgia Articolare Sostitutiva e Chirurgia Ortopedica - Piede e Caviglia, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milan, Italy. Electronic address: riccardo.dambrosi@hotmail.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: D'Ambrosi
authors.affiliation: Chirurgia Articolare Sostitutiva e Chirurgia Ortopedica - Piede e Caviglia, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milan, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Maccario
authors.affiliation: Dipartimento di Radiologia, Seconda Università degli Studi di Napoli, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Serra
authors.affiliation: Chirurgia Articolare Sostitutiva e Chirurgia Ortopedica - Piede e Caviglia, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milan, Italy; Dipartimento di Ortopedia e Traumatologia, Ospedale Santa Maria, Borgo Val di Taro, Parma, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Liuni
authors.affiliation: Chirurgia Articolare Sostitutiva e Chirurgia Ortopedica - Piede e Caviglia, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milan, Italy.
authors.forename: Federico Giuseppe
authors.initials: FG
authors.lastname: Usuelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002111:Calcaneus / Q000637:transplantation*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D020219:Chondrogenesis; D003094:Collagen / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D048091:Guided Tissue Regeneration / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011379:Prognosis; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D055815:Young Adult
chemical_list: D003094:Collagen