Matrix-associated stem cell transplantation is successful in treating talar osteochondral lesions

Purpose Osteochondral lesions (OCLs) of the talus are a challenging and increasingly recognized problem in chronic ankle pain. Many novel techniques exist to try and treat this challenging entity. Difficulties associated with treating OCLs include lesion location, size, chronicity, and problems asso...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2019-09, Vol.27 (9), p.2737-2743
Main Authors: Murphy, Evelyn P., Fenelon, Christopher, Egan, Ciara, Kearns, Stephen R.
Format: Article
Language:English
Subjects:
Ankle
Biocompatibility
Chronic pain
Domains
Lesions
Medicine
Medicine & Public Health
Microfracture
Orthopedics
Pain
Patients
Radiographs
Radiography
Stem cell transplantation
Stem cells
Surgery
Talus
Transplantation
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Summary:Purpose Osteochondral lesions (OCLs) of the talus are a challenging and increasingly recognized problem in chronic ankle pain. Many novel techniques exist to try and treat this challenging entity. Difficulties associated with treating OCLs include lesion location, size, chronicity, and problems associated with potential graft harvest sites. Matrix-associated stem cell transplantation (MAST) is one such treatment described for larger lesions > 15 mm 2 or failed alternative therapies. This cohort study describes a 3 year review of the outcomes of talar lesions treated with MAST. Methods A review of all patients treated with MAST by a single surgeon was conducted. Pre-operative radiographs, MRIs, and FAOS outcome questionnaire scores were reviewed. Intraoperative classification was undertaken to correlate with imaging. Post-operative outcomes included FAOS scores, return to sport, revision surgery/failure of treatment, and progression to ankle fusion. Results In this study, 38 OCLs in 32 patients were identified. Median patient age was 35 years of which (68.8%) were male. Median length of follow-up was 36.7 months (range 12–64 months). (83%) returned to playing sport. Twenty-three patients underwent MAST in the setting of a failed previous operative attempt, with just nine having MAST as a first option. Nine patients out of 32 had a further procedure. Improvements were seen in all domains of the FAOS ( p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-019-05452-z