Background: To assess the functional and radiological outcomes after arthroscopic talus autologous matrix-induced chondrogenesis (AT-AMIC®) in 2 groups: patients with and without bone marrow edema (BME). Methods: Thirty-seven patients of which 24 without edema (GNE) and 13 with edema (GE) were evaluated. All patients were treated with AT-AMIC® repair for symptomatic osteochondral talar lesion. Clinical and radiological parameters were evaluated with VAS score for pain, AOFAS and SF-12 at T0 (preoperatively), T1 (6 months), T2 (12 months), T3 (24 months) and MRI and CT-scan at T0, T1, T2 and T3. Results: No patients were lost to the final follow-up. In both groups we found a significant difference for clinical and radiological parameters with ANOVA for repeated measures through four time points (p < 0.001). In GNE, AOFAS improved significantly at each follow-up (p < 0.05); while CT and MRI showed a significant reduction in lesion size between T1 and T2 and T2 and T3 (p < 0.05). In GE, AOFAS improved significantly between T0 and T1 and T2 and T3 (p < 0.05); lesion size, measured with CT, decreased between T1 and T2 (p < 0.05), while with MRI the lesion showed a reduction at each follow-up (p < 0.05). Lesion size was significantly higher both in MRI and CT in GE compared to GNE (p < 0.05). In GNE no patients presented edema at T3, while in GE only 23.08% of the patients presented edema at T3. Conclusions: The study revealed that osteochondral lesions of the talus were characterized by bigger size both in MRI and CT in patients with edema. We conclude that AT-AMIC® can be considered a safe and reliable procedure that allows effective healing, regardless of edema and more than half of patients did not present edema six months after surgery.

The role of bone marrow edema on osteochondral lesions of the talus / R. D'Ambrosi, C. Maccario, C. Ursino, N. Serra, F.G. Usuelli. - In: FOOT AND ANKLE SURGERY. - ISSN 1268-7731. - 24:3(2018), pp. 229-235. [10.1016/j.fas.2017.02.010]

The role of bone marrow edema on osteochondral lesions of the talus

R. D'Ambrosi
Primo
;
C. Maccario;
2018

Abstract

Background: To assess the functional and radiological outcomes after arthroscopic talus autologous matrix-induced chondrogenesis (AT-AMIC®) in 2 groups: patients with and without bone marrow edema (BME). Methods: Thirty-seven patients of which 24 without edema (GNE) and 13 with edema (GE) were evaluated. All patients were treated with AT-AMIC® repair for symptomatic osteochondral talar lesion. Clinical and radiological parameters were evaluated with VAS score for pain, AOFAS and SF-12 at T0 (preoperatively), T1 (6 months), T2 (12 months), T3 (24 months) and MRI and CT-scan at T0, T1, T2 and T3. Results: No patients were lost to the final follow-up. In both groups we found a significant difference for clinical and radiological parameters with ANOVA for repeated measures through four time points (p < 0.001). In GNE, AOFAS improved significantly at each follow-up (p < 0.05); while CT and MRI showed a significant reduction in lesion size between T1 and T2 and T2 and T3 (p < 0.05). In GE, AOFAS improved significantly between T0 and T1 and T2 and T3 (p < 0.05); lesion size, measured with CT, decreased between T1 and T2 (p < 0.05), while with MRI the lesion showed a reduction at each follow-up (p < 0.05). Lesion size was significantly higher both in MRI and CT in GE compared to GNE (p < 0.05). In GNE no patients presented edema at T3, while in GE only 23.08% of the patients presented edema at T3. Conclusions: The study revealed that osteochondral lesions of the talus were characterized by bigger size both in MRI and CT in patients with edema. We conclude that AT-AMIC® can be considered a safe and reliable procedure that allows effective healing, regardless of edema and more than half of patients did not present edema six months after surgery.
Ankle arthroscopy; Autologous matrix-induced chondrogenesis; Bone marrow edema; Osteochondral talar lesions
Settore MED/33 - Malattie Apparato Locomotore
2018
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/946856
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