title: Return to Sports After Bone Marrow-Derived Cell Transplantation for Osteochondral Lesions of the Talus.
abstract: OBJECTIVE
  Arthroscopic "one-step" technique based on bone marrow-derived cell transplantation (BMDCT) have achieved good results in repairing osteochondral lesions of the talus (OLT), overcoming important drawbacks of older techniques. It may be particularly adequate for the treatment of athletes in order to permit a safe and stable return to sports. The aim of this study was to report the results at 48 months of a series of athletes and the factors influencing the return to sports.
  
  
  METHODS
  Case series. A total of 140 athletes underwent a "one-step" BMDCT repair of OLT. All the patients had the cells harvested from the iliac crest, condensed and loaded on a scaffold, and then implanted. Patients were evaluated clinically by the American Orthopaedic Foot and Ankle Society (AOFAS) scores and Halasi score.
  
  
  RESULTS
  AOFAS score improved from 58.7 ± 13.5 preoperatively to 90.6 ± 8.6 (P< 0.005) at 24 months, and to 90.9 ± 10.7 at 48 months. Halasi score was 6.88 ± 1.8 preinjury, 4.08 ± 1.7 preoperatively, and 5.56 ± 2.0 at final follow-up. At the final follow-up, all the patients (beside 1 failure and 3 lost) were able to return to activity and 72.8% were able to resume sports at preinjury level.
  
  
  CONCLUSIONS
  "One-step" BMDCT repair of OLT had good clinical results that was durable over time in athletes, permitting a return to sports at preinjury level in the majority of patients. The preoperative presence of impingement and articular degeneration were the main negative prognostic factors.
authors.affiliation: First Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Vannini
authors.affiliation: First Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallo
authors.affiliation: First Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Ramponi
authors.affiliation: First Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castagnini
authors.affiliation: First Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Massimi
authors.affiliation: Bologna University, Bologna, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
authors.affiliation: First Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Roberto Emanuele
authors.initials: RE
authors.lastname: Buda
keywords: ankle; articular cartilage; cartilage repair; mesenchymal stem cells; sports injury