Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Germany.
Foot Ankle Surg. 2013 Jun;19(2):84-90. doi: 10.1016/j.fas.2012.11.005. Epub 2012 Dec 21.
The aim of the study was to assess the feasibility and clinical results of matrix-associated stem cell transplantation (MAST) and 2-year-follow-up in chondral defects of foot and ankle.
In a prospective, consecutive, non-controlled clinical follow-up study, all patients with chondral defects, that were treated with MAST from April 1st to November 30th, 2009 were analyzed. The size and location of the chondral defects, method-associated problems and the Visual Analogue Scale Foot and Ankle (VAS FA) before treatment and at follow-up were registered and analyzed.
Twenty-six chondral defects in 25 patients were included in the study. The mean age of the patients was 33 years (range, 16-48 years), 18 (72%) were male. The VAS FA before surgery was 49.2 on average (range, 24.3-68.4). The defects were located as follows: medial talar shoulder, n=9; lateral talar shoulder, n=13 (medial and lateral talar shoulder, n=1); distal tibia, n=1; posterior calcaneal facet, n=1; head of 1st metatarsal, n=2. The defect size was 1.1cm(2) on average (range, .5-6 cm(2)). All patients completed 2-year-followup. No complications or consecutive surgeries were registered. The mean VAS FA at follow-up was 94.5 (range, 73.4-100; t-test, p<.01).
MAST led to good clinical scores. No complications were registered. Even though a control group is missing, we conclude that MAST is a safe and effective method for the treatment of chondral defects. The main advantage of MAST in comparison with ACI and MACI is the single procedure methodology. The advantage in comparison with AMIC is the potential higher concentration of stem cells.
本研究旨在评估基质相关干细胞移植（MAST）治疗足部和踝关节软骨缺损的可行性和临床结果，并进行 2 年随访。
采用前瞻性、连续、非对照临床随访研究，分析 2009 年 4 月 1 日至 11 月 30 日期间采用 MAST 治疗的所有软骨缺损患者。记录并分析软骨缺损的大小和位置、与方法相关的问题以及治疗前和随访时的视觉模拟评分足部和踝关节（VAS FA）。
25 例患者的 26 个软骨缺损纳入研究。患者平均年龄 33 岁（16-48 岁），男性 18 例（72%）。手术前 VAS FA 平均为 49.2（24.3-68.4）。缺损部位如下：内侧距骨肩，9 例；外侧距骨肩，13 例（内侧和外侧距骨肩，1 例）；胫骨远端，1 例；跟骨后关节面，1 例；第 1 跖骨头，2 例。缺损大小平均为 1.1cm(2)（0.5-6 cm(2)）。所有患者均完成 2 年随访。未记录到并发症或后续手术。随访时平均 VAS FA 为 94.5（73.4-100；t 检验，p<.01）。
MAST 可获得良好的临床评分，未记录到并发症。尽管缺乏对照组，但我们认为 MAST 是治疗软骨缺损的一种安全有效的方法。与 ACI 和 MACI 相比，MAST 的主要优势在于单次手术方法。与 AMIC 相比，其优势在于潜在更高浓度的干细胞。
