Artikel
Functional medium term results after autologous matrix-induced chondrogenesis (AMIC) for osteochondral lesions of the talus – A 5 years prospective cohort study
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Autoren
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Oliver Gottschalk
- Schön Klinik München Harlaching, München, Germany
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Sebastian Altenberger
- Schön Klinik München Harlaching, München, Germany
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Sebastian Baumbach
- Schoen-Klinik München Harlaching, Klinik für Allgemeine-, Unfallchirurgie LMU, München, Germany
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Markus Walther
- Schön Klinik München Harlaching, München, Germany
| Veröffentlicht: | 23. Oktober 2017 |
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Gliederung
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Objectives: Autologous matrix induced chondrogenesis (AMIC) has gained increasing popularity in Europe in the treatment of osteochondral lesions of the talus. Previous studies presented promising short-term results for the usage of the I/III collagen bilayer matrix. The aim of this study was to investigate the long-term effect of AMIC procedure for the talus.
Methods: The 5-year results of a prospective cohort study are presented. All patients underwent an open AMIC procedure without malleolar osteotomy for a talar osteochondral lesion. Data analysis included general demographics, preoperative MRI findings, intraoperative details and Foot-Function-Index (FFI-D) pre-, one-, and five years following surgery. The primary outcome variable was the longitudinal effect of the procedure. Furthermore the influence of various variables on the outcome was tested.
Results and Conclusion: 21 (45%) out of 47 patients treated met the inclusion criteria. 8 (38%) female and 13 (62%) mail patients have been included, with a mean age of 37±15 years (15-62 years) and a BMI of 26±5 kg/m2 (20-38 kg/m2). The defect size was 1.4 cm2±0.9 cm2 (0.2-4.0 cm2). The defect location was found medial in 76%, central in 10%, and lateral in 14%. 95% of the patients received additional procedures. The FFI-D decreased significantly from pre- to one-year post-operative (56±18 vs. 33±25; p=0.003), with a further, non-significant decrease between one- and five-year follow-up (33±25 vs. 24±21; p=0.457). Similar results were found on the score's subscale function and pain. The subscale of sports activity did not show a significant change compared to the preoperative situation. Only age, BMI and size of lesion showed a moderate, but significant positive correlation to the level of preoperative FFI-D and its subscales.
The results show that there is a significant improvement in pain and function after AMIC procedure, however this improvement did not lead to a higher sports activity level compared to the preoperative situation. The biggest improvement is seen within the first year, but further clinical satisfaction amongst the patients is noticeable after 5 years.
