Prognosis of MACI (matrix-associated autologous chondrocyte implantation) after osteochondral lesions of the talus
ESSKA Academy. Ateschrang A. Nov 8, 2019; 284351; epAFAS-15
Atesch Ateschrang
Atesch Ateschrang
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Prognosis of MACI (matrix-associated autologous chondrocyte implantation) after osteochondral lesions of the talus

ePoster - epAFAS-15

Topic: Cartilage

Ateschrang A., Gronbach H.T., Ahrend M.D., Schreiner A.J.
BG Trauma Center Tübingen, Tübingen, Germany

Introduction: Osteochondral lesions of the talus (OLT) may be addressed by different surgical options. The matrix-associated autologous chondrocyte implantation (MACI) offers the possibility to use endogenous respectively autologous hyaline articular cartilage for filling the defect. So far, there are little studies regarding the evaluation of this method. The purpose of this study is the analysis and prognosis of the subjective as well as objective treatment results after MACI.
Objectives: The surgical treatment method MACI is evaluated and the prognosis is presented.
Aims: This study aims to better understand and evaluate the role of the surgical option MACI in the treatment of OLT.
Methods: 71 patients (m/f 55%/45%; mean age 33y) who underwent a MACI-procedure due to an OLT were analysed in a consecutive series. Informed consent was obtained and the study was approved by the local recognized medical ethics committee. Besides the collection of general medical data, a clinical examination as well as the assessment of several scores with regards to function and quality of life were performed (VAS, VASFA, AOFAS, FAOS, EQ-5D-3L). Statistical analysis (binominal-, t-, chi-quadrat-test; level of significance < 0,05) was performed with IBM SPSS.
Results: The mean follow-up was 44 (13-83) months. 75% of all patients presented an OD and 66% of all patients have had a positive trauma history. According to Outerbridge/ICRS the lesion (medial talus 74.6%) was classified stage 2/3/4 in 24%/28%/48% with an average size of 2.3 cm². There occurred no intra- or postoperative adverse events. Ankle joint instability was reduced from pre- to postoperatively from 26% to 9% and joint mobility improved in 90% of all cases by a mean of 11°. Pain according to the VAS significantly decreased and 83% of all patients could resume their former sports activities. The VASFA and AOFAS score improved from 58/70 to 81/89 points (max. 100). The FAOS score as well as the EQ-5D-3L significantly increased in all 5 categories/dimensions as well. Further surgery was necessary in 19% of all cases (debridement, microfracturing, osteophyte resection).
Conclusions: Good to very good results regarding the postoperative improvement in the categories symptoms, pain, sports, function and quality of life can be achieved and 71% of all patients were satisfied with the postoperative result. The MACI is a good and advisable treatment option for the therapy of OLT.
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