Seven-Year Follow-up of Matrix-Induced Autologous Implantation in Talus Articular Defects

Foot Ankle Spec. 2018 Apr;11(2):133-137. doi: 10.1177/1938640017713614. Epub 2017 Jun 6.

Abstract

Background: Osteochondral lesions of the talus (OLT) are difficult to treat because of the poor intrinsic healing capability of articular cartilage. Matrix-induced autologous chondrocyte implantation (MACI) has been shown to be a reliable method for treating cartilage lesions that fail to respond to traditional microfracture and debridement. The purpose of this study was to assess 7-year clinical follow-up data of this technique and demonstrate midterm success of this implant.

Methods: A prospective investigation of MACI was performed on 10 patients with OLTs who had failed previous arthroscopic treatment. In all, 5 male and 5 female patients were included in the study. Of the 10 patients, 9 were available for 7-year follow-up. Functional and clinical evaluations were done at 7 years postoperatively using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot evaluation and the Short Form Health Survey (SF-36) and compared with preoperative values.

Results: SF-36 data at 7 years showed significant improvements in Physical Functioning (P < .01), Lack of Bodily Pain (P < .1), and Social Functioning (P < .001) compared with preoperative data. The mean AOFAS hindfoot scores of the 9 patients at 7 years was 78.3 ± 18.1 (P = .05) compared with their preoperative mean of 61.8 ± 14.3.

Conclusions: MACI provides a stable midterm chondral replacement strategy for osteochondral lesions that fail initial microfracture.

Levels of evidence: Level IV: Prospective case series.

Keywords: MACI; matrix assisted chondrocyte implantation; osteochondral lesion of the talus; talus.

MeSH terms

  • Ankle Joint / diagnostic imaging
  • Ankle Joint / surgery*
  • Arthroscopy / methods
  • Cartilage, Articular / surgery*
  • Chondrocytes / transplantation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Talus / diagnostic imaging
  • Talus / surgery*
  • Time Factors
  • Tissue Engineering / methods*
  • Transplantation, Autologous
  • Treatment Outcome