2017 ISAKOS Biennial Congress ePoster #132

 

Matrix-Induced Autologous Chondrocyte Implantation of Talus Osteochondral Defect

Bing Wu, MD, Shenzhen, Guangdong CHINA
Wei Lu, MD, PhD, Prof., Shenzhen, Guangdong CHINA
Daping Wang, Shenzhen, Quong Dong Province CHINA
Weimin Zhu, MD, Shenzhen, Guangdong CHINA
Kan Ouyang, Shenzhen CHINA
Haifeng Liu, PhD, Shenzhen, Guangdong CHINA

Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University (Shenzhen Second People Hospital), Shenzhen, Guangdong, CHINA

FDA Status Not Applicable

Summary

Matrix-induced autologous chondrocyte implantation (MACI) in the treatment of talus osteochondral defects was performed with a mean follow-up time of (35. 3±5.6 )months, which can obtain good clinical outcomes.

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Abstract

Objective

To evalulate clinical outcomes of Matrix-induced autologous chondrocyte implantation (MACI) in the treatment of talus osteochondral defects .

Methods

From March 2012 to September 2013, a prospective investigation of MACI (Matrix-induced Autologous Chondrocyte Implantation)was performed on eleven patients with full-thickness osteochondral lesions of the talus( OLT), who had gotten poor response to conservative treatment and (or) ankle debridement and microfracture. 11 cases ( 8 male and 3 female)were enrolled into the study with a mean age of( 32. 6±1.4)years old ( range of 21 to 48 years old) and a mean defective area of (3.4±0.6)cm2( range of 2.0 to 5.8cm2). Arthroscopy, debridement and cartilage harvesting procedure was performed in the first operation. After 2 to 4 weeks of preparation of tissue engineering cartilage, autologous grafting and sealing of the defect with fibrin glue was perfomed. All patients were regularly followed up. VAS score, AOFAS score and magnetic resonance observation of cartilage repair tissue( MOCART)were measured for assessment of clinical outcomes.

Results

All surgeries were performed successfully with a mean follow-up time of (35. 3±5.6 )months( range from 26 to 50 months). The VAS score, AOFAS score and MOCART score at the final follow-up were significantly improved compared with preoperation( [0.8±0.6]vs[7.8±1.4] points, [94.8±1.9]vs[94.8±1.9] points, [6.5±0.4]vs[3.6±0.8] points, P<0.05). Complete filling of the defect at the level of the surrounding cartilage was found in 54.5%( 6 cases), and complete filling with a hypertrophic cartilage layer was found in 27.3%( 4 cases) of the patients. Normal signal intensity of the repair tissue compared with the adjacent native cartilage was seen in 18.2%( 2 cases), with nearly normal activity in 81.8%( 8 cases). Eight patients ( 72.7%) returned to previous sport activity. 2 cases ( 18.2%) got mild limitation of ankle joint range of motion ( ROM).

Conclusions

MACI therapy for OLT can obtain good clinical outcomes, which is safe ,reliable and worthy of clinical popularization and application.