Comparison of Juvenile Allogenous Articular Cartilage and Bone Marrow Aspirate Concentrate Versus Microfracture With and Without Bone Marrow Aspirate Concentrate in Arthroscopic Treatment of Talar Osteochondral Lesions.

Autor:	Karnovsky SC; 1 Hospital for Special Surgery, New York, NY, USA., DeSandis B; 1 Hospital for Special Surgery, New York, NY, USA., Haleem AM; 2 Department of Orthopedic Surgery, Oklahoma University College of Medicine Health Sciences Center, Oklahoma City, OK, USA.; 3 Department of Orthopedic Surgery, Kasr Al-Ainy College of Medicine, Cairo University, Cairo, Egypt., Sofka CM; 4 Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA., O'Malley M; 5 Department of Orthopedic Surgery, Foot and Ankle, Hospital for Special Surgery, New York, NY, USA., Drakos MC; 5 Department of Orthopedic Surgery, Foot and Ankle, Hospital for Special Surgery, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Foot & ankle international [Foot Ankle Int] 2018 Apr; Vol. 39 (4), pp. 393-405. Date of Electronic Publication: 2018 Jan 11.
DOI:	10.1177/1071100717746627
Abstrakt:	Background: The purpose of this study was to compare the functional and radiographic outcomes of patients who received juvenile allogenic chondrocyte implantation with autologous bone marrow aspirate (JACI-BMAC) for treatment of talar osteochondral lesions with those of patients who underwent microfracture (MF). Methods: A total of 30 patients who underwent MF and 20 who received DeNovo NT for JACI-BMAC treatment between 2006 and 2014 were included. Additionally, 17 MF patients received supplemental BMAC treatment. Retrospective chart review was performed and functional outcomes were assessed pre- and postoperatively using the Foot and Ankle Outcome Score and Visual Analog pain scale. Postoperative magnetic resonance images were reviewed and evaluated using a modified Magnetic Resonance Observation of Cartilage Tissue (MOCART) score. Average follow-up for functional outcomes was 30.9 months (range, 12-79 months). Radiographically, average follow-up was 28.1 months (range, 12-97 months). Results: Both the MF and JACI-BMAC showed significant pre- to postoperative improvements in all Foot and Ankle Outcome Score subscales. Visual Analog Scale scores also showed improvement in both groups, but only reached a level of statistical significance ( P < .05) in the MF group. There were no significant differences in patient reported outcomes between groups. Average osteochondral lesion diameter was significantly larger in JACI-BMAC patients compared to MF patients, but size difference had no significant impact on outcomes. Both groups produced reparative tissue that exhibited a fibrocartilage composition. The JACI-BMAC group had more patients with hypertrophy exhibited on magnetic resonance imaging (MRI) than the MF group ( P = .009). Conclusion: JACI-BMAC and MF resulted in improved functional outcomes. However, while the majority of patients improved, functional outcomes and quality of repair tissue were still not normal. Based on our results, lesions repaired with DeNovo NT allograft still appeared fibrocartilaginous on MRI and did not result in significant functional gains as compared to MF. Level of Evidence: Level III, comparative series.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu