Purpose To assess and evaluate healing and functional outcomes after arthroscopic talus autologous matrix-induced chondrogenesis (AT-AMIC) in 2 age groups: patients older than 33 years versus patients 33 years or younger. Methods A total of 31 patients, of whom 17 were 33 years or younger (G1) and 14 older than 33 years (G2), were evaluated. All patients were treated with AT-AMIC repair for osteochondral talar lesion. Magnetic resonance imaging (MRI) and computed tomography (CT)-scan evaluations, as well as clinical evaluations measured by the visual analog scale (VAS) score for pain, American Orthopaedic Foot and Ankle Society Ankle and Hindfoot score (AOFAS), and Short Form-12, were performed preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively. Results G1 consisted of 17 patients (mean age: 25 years, standard deviation: ±5), whereas G2 consisted of 14 patients (mean age: 47 years, standard deviation: ±9). In both groups, we found a significant difference for clinical and radiological parameters with the analysis of variance for repeated measures through 4 time points (P < .001). In G1, AOFAS improved significantly between T0 and T1 (P = .025) and T1 and T2 (P = .011); CT showed a significant decrease between T1 and T2 (P = .003) and T2 and T3 (P < .0001), whereas MRI reduced significantly at each follow-up. In G2, AOFAS improved between T0 and T1 (P = .011) and T2 and T3 (P = .018); CT decreased between T1 and T2 (P = .025), whereas MRI showed a reduction between T1 and T2 (P = .029) and T2 and T3 (P = .006). AOFAS in G1 was significantly higher at T0 (P = .017), T2 (P = .036), and T3 (P = .039) compared with G2. A negative linear correlation between AOFAS and VAS at T1 (R = −0.756), T2 (R = −0.637), and T3 (R = −0.728) was found in G1, whereas in G2, AOFAS was negatively correlated with VAS at T1 (R = −0.702). Conclusions The study revealed that osteochondral lesions of the talus were characterized by similar sizes and features, both in young and old patients. We conclude that AT-AMIC can be considered a safe and reliable procedure that allows effective healing, regardless of age, with a significant clinical improvement; in particular, clinical results are related to starting conditions of the ankle. Level of Evidence Level IV, therapeutic case series.

Osteochondral Lesions of the Talus and Autologous Matrix-Induced Chondrogenesis: Is Age a Negative Predictor Outcome? / R. D'Ambrosi, C. Maccario, N. Serra, F. Liuni, F.G. Usuelli. - In: ARTHROSCOPY. - ISSN 0749-8063. - 33:2(2017 Feb 01), pp. 428-435. [10.1016/j.arthro.2016.09.030]

Osteochondral Lesions of the Talus and Autologous Matrix-Induced Chondrogenesis: Is Age a Negative Predictor Outcome?

R. D'Ambrosi
Primo
;
2017

Abstract

Purpose To assess and evaluate healing and functional outcomes after arthroscopic talus autologous matrix-induced chondrogenesis (AT-AMIC) in 2 age groups: patients older than 33 years versus patients 33 years or younger. Methods A total of 31 patients, of whom 17 were 33 years or younger (G1) and 14 older than 33 years (G2), were evaluated. All patients were treated with AT-AMIC repair for osteochondral talar lesion. Magnetic resonance imaging (MRI) and computed tomography (CT)-scan evaluations, as well as clinical evaluations measured by the visual analog scale (VAS) score for pain, American Orthopaedic Foot and Ankle Society Ankle and Hindfoot score (AOFAS), and Short Form-12, were performed preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively. Results G1 consisted of 17 patients (mean age: 25 years, standard deviation: ±5), whereas G2 consisted of 14 patients (mean age: 47 years, standard deviation: ±9). In both groups, we found a significant difference for clinical and radiological parameters with the analysis of variance for repeated measures through 4 time points (P < .001). In G1, AOFAS improved significantly between T0 and T1 (P = .025) and T1 and T2 (P = .011); CT showed a significant decrease between T1 and T2 (P = .003) and T2 and T3 (P < .0001), whereas MRI reduced significantly at each follow-up. In G2, AOFAS improved between T0 and T1 (P = .011) and T2 and T3 (P = .018); CT decreased between T1 and T2 (P = .025), whereas MRI showed a reduction between T1 and T2 (P = .029) and T2 and T3 (P = .006). AOFAS in G1 was significantly higher at T0 (P = .017), T2 (P = .036), and T3 (P = .039) compared with G2. A negative linear correlation between AOFAS and VAS at T1 (R = −0.756), T2 (R = −0.637), and T3 (R = −0.728) was found in G1, whereas in G2, AOFAS was negatively correlated with VAS at T1 (R = −0.702). Conclusions The study revealed that osteochondral lesions of the talus were characterized by similar sizes and features, both in young and old patients. We conclude that AT-AMIC can be considered a safe and reliable procedure that allows effective healing, regardless of age, with a significant clinical improvement; in particular, clinical results are related to starting conditions of the ankle. Level of Evidence Level IV, therapeutic case series.
Settore MED/33 - Malattie Apparato Locomotore
9-dic-2016
Article (author)
File in questo prodotto:
File Dimensione Formato  
10.1016@j.arthro.2016.09.030.pdf

accesso aperto

Descrizione: online first
Tipologia: Publisher's version/PDF
Dimensione 481.68 kB
Formato Adobe PDF
481.68 kB Adobe PDF Visualizza/Apri
PIIS0749806316307903.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 480.39 kB
Formato Adobe PDF
480.39 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/946886
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 30
  • ???jsp.display-item.citation.isi??? 29
social impact