Götze Christian, Nieder Christian, Felder Hanna, Migliorini Filippo
Department of Orthopaedic Surgery, Auguste-Viktoria Clinic, Ruhr University Bochum, 32545 Bad Oeynhausen, Germany.
Department of Orthopaedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, Germany.
Life (Basel). 2020 Dec 5;10(12):328. doi: 10.3390/life10120328.
The management of a focal osteochondral lesion of the talus (OLT) is challenging. Evidence concerning the role of the autologous matrix-induced chondrogenesis (AMIC) procedure in patients with focal OLT is promising. The purpose of the present study was to investigate clinical outcomes and radiographic findings of the AMIC technique for focal unipolar OLT.
The present study was performed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Twenty-four patients who underwent AMIC for focal OLT were prospectively recruited at our institution. All the surgeries were performed by two experienced surgeons through malleolar osteotomy and autologous cancellous bone grafting. The outcomes of interest were the American orthopedic foot and ankle score (AOFAS), the foot-function index (FFI), and the magnetic resonance observation of cartilage repair tissue (MOCART). Surgical duration, hospitalization length, and complications were also collected.
24 patients were included in the present study. The mean follow-up was 25.17 ± 13.1 months. The mean age of the patients at surgery was 46.75 ± 15.2 years, the mean BMI 26.92 ± 5.7 kg/m, and 50% (12 of 24) of patients were female. The right ankle was involved in 62.5% (15 of 24) of patients. The mean defect size was 6.95 ± 2.9 mm. The mean surgical duration was 112 ± 20 min while the mean hospitalization 5.58 ± 1.7 days. At last follow-up, the AOFAS increased by 27.8 points ( < 0.0001), while the FFI reduced by 25.3 points ( < 0.0001) and the MOCART score increased by 28.33 points ( < 0.0001). No complications were observed.
The AMIC procedure for focal osteochondral defects of the talar shoulder is feasible and reliable at midterm follow-up.
距骨局灶性骨软骨损伤（OLT）的治疗具有挑战性。关于自体基质诱导软骨形成（AMIC）手术在局灶性OLT患者中的作用的证据很有前景。本研究的目的是调查AMIC技术治疗局灶性单极OLT的临床结果和影像学表现。
本研究按照加强流行病学观察性研究报告（STROBE）指南进行。在我们机构前瞻性招募了24例行AMIC治疗局灶性OLT的患者。所有手术均由两名经验丰富的外科医生通过踝关节截骨术和自体松质骨移植进行。感兴趣的结果指标包括美国矫形足踝评分（AOFAS）、足部功能指数（FFI）和软骨修复组织的磁共振观察（MOCART）。还收集了手术时间、住院时间和并发症情况。
本研究纳入24例患者。平均随访时间为25.17±13.1个月。患者手术时的平均年龄为46.75±15.2岁，平均体重指数为26.92±5.7kg/m²，50%（24例中的12例）为女性。62.5%（24例中的15例）患者累及右踝。平均缺损大小为6.95±2.9mm。平均手术时间为112±20分钟，平均住院时间为5.58±1.7天。在最后一次随访时，AOFAS增加了27.8分（P<0.0001），而FFI降低了25.3分（P<0.0001），MOCART评分增加了28.33分（P<0.0001）。未观察到并发症。
距骨肩部局灶性骨软骨缺损的AMIC手术在中期随访时是可行且可靠的。
