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Clinical outcome and T2 assessment following autologous matrix-induced chondrogenesis in osteochondral lesions of the talus

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Abstract

Purpose

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.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Clinic for Orthopaedic and Trauma Surgery, University Medical Centre, Albert-Ludwigs University Freiburg, Freiburg, Germany

    Eva Johanna Kubosch, Benjamin Erdle, Kaywan Izadpanah, David Kubosch, Norbert P. Südkamp & Philipp Niemeyer

  2. Department of Radiology, St. Josef’s Hospital, Sautierstraße 1, 79104, Freiburg, Germany

    Markus Uhl

Authors
  1. Eva Johanna Kubosch
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  2. Benjamin Erdle
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  3. Kaywan Izadpanah
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  4. David Kubosch
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  6. Norbert P. Südkamp
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  7. Philipp Niemeyer
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Correspondence to Eva Johanna Kubosch.

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Kubosch, E.J., Erdle, B., Izadpanah, K. et al. Clinical outcome and T2 assessment following autologous matrix-induced chondrogenesis in osteochondral lesions of the talus. International Orthopaedics (SICOT) 40, 65–71 (2016). https://doi.org/10.1007/s00264-015-2988-z

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  • DOI: https://doi.org/10.1007/s00264-015-2988-z

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