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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-03-2018 | Ankle

All-arthroscopic AMIC^® (AT-AMIC^®) technique with autologous bone graft for talar osteochondral defects: clinical and radiological results

Authors: Federico Giuseppe Usuelli, Riccardo D’Ambrosi, Camilla Maccario, Michele Boga, Laura de Girolamo

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2018

Abstract

Purpose

Autologous Matrix-Induced Chondrogenesis (AMIC^®) is known to provide satisfactory clinical results for the treatment of knee, hip, and ankle cartilage lesions. The purpose of this study was to evaluate clinical and radiological outcomes of patients treated with a new all-arthroscopic AMIC^® (AT-AMIC^®) technique with autologous bone graft for talar osteochondral defects at a follow-up of 24 months.

Methods

Twenty patients underwent the AT-AMIC^® procedure and autologous bone graft for type III and IV talar osteochondral lesions. Patients were evaluated pre-operatively and at 6, 12, and 24 months post-operatively using the American Orthopedic Foot and Ankle Society (AOFAS) score, the visual analog scale, and the SF-12 (Short Form-12). Radiological assessment included computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance observation of cartilage repair tissue (MOCART).

Results

All scores significantly improved (p < 0.05) with respect to pre-operative values after 6 months. Further improvements were detected at 24 months (AOFAS, from 57.1 ± 14.9 before surgery to 86.6 ± 10.9 after 24 months; VAS, from 8.1 ± 1.4 to 2.5 ± 2.2; SF-12, from 29.9 ± 4.1 to 48.5 ± 6.9 and from 43.8 ± 2.9 to 53.1 ± 3.9, respectively, for Physical and Mental component score). Lesion area significantly reduced from 111.1 ± 43.2 mm² pre-operatively to 76.9 ± 38.1 mm² (p < 0.05) at final follow-up as assessed by CT, and from 154.1 ± 93.6 to 94.3 ± 61.3 mm² (p < 0.05) as assessed by MRI. The mean MOCART score was 42.8 ± 23.5 points and 50.9 ± 24.9 points, respectively, at 12 and 24 months after surgery (p < 0.05).

Conclusions

AT-AMIC^® with autologous bone grafting has proven to be a safe and effective minimal invasive technique, able to rapidly and significantly improve pain, function, and radiological healing of osteochondral talar lesions, with progressive further improvements up to 24 months. Orthopedic surgeons specialized in foot and ankle surgery should adopt the AT-AMIC^® technique for the treatment of osteochondral talar lesions, which proved to be effective and minimally invasive, avoiding malleolar osteotomy with a low risk of complications.

Level of evidence

IV.

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Title: All-arthroscopic AMIC® (AT-AMIC®) technique with autologous bone graft for talar osteochondral defects: clinical and radiological results
Authors: Federico Giuseppe Usuelli
Riccardo D’Ambrosi
Camilla Maccario
Michele Boga
Laura de Girolamo
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-016-4318-4

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Springer Medicine

All-arthroscopic AMIC^® (AT-AMIC^®) technique with autologous bone graft for talar osteochondral defects: clinical and radiological results

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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