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Archives of Orthopaedic and Trauma Surgery

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01-01-2016 | Arthroscopy and Sports Medicine

“One-step” bone marrow-derived cells transplantation and joint debridement for osteochondral lesions of the talus in ankle osteoarthritis: clinical and radiological outcomes at 36 months

Authors: Roberto Buda, Francesco Castagnini, Marco Cavallo, Laura Ramponi, Francesca Vannini, Sandro Giannini

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2016

Abstract

Introduction

Ankle osteoarthritis (OA) is a challenging pathology, often requiring surgical treatments. In young patients, joint sparing, biologic procedures would be desirable. Recently, a few reports have described the efficacy of bone marrow stem cells in OA. Considering the good outcomes of one-step bone marrow derived cells transplantation (BMDCT) for osteochondral lesions of the talus (OLT), we applied this procedure for OLT in concomitant ankle OA.

Materials and methods

56 patients, with a mean age of 35.6 years (range 16–50), who suffered from OLT and ankle OA, were treated using BMDCT. All patients were clinically checked using AOFAS score, in the pre-operative setting until the final follow-up of 36 months. Weight-bearing radiographs and MRI evaluation using Mocart score were performed, preoperatively and postoperatively.

Results

The whole clinical outcome had a remarkable improvement at 12 months, a further amelioration at 24 months and a lowering trend at 36 months (77.8 ± 18.3). Early OA had better outcomes. 16 patients required another treatment and they were considered failures. Clinical outcome significantly correlates with OA degree, BMI, associate procedures. Radiographs were in line with clinical results. MRI evaluation showed signs of osteochondral repair.

Conclusions

BMDCT showed encouraging clinical and radiological outcomes at short-term follow-up. This procedure should be applied in young and selected patients, excluding severe ankle degeneration, where the results are critical. Longer follow-ups and larger case series are needed to confirm these results and if this treatment could be effective in postponing end-stage procedures.

Level of evidence

IV.

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Title: “One-step” bone marrow-derived cells transplantation and joint debridement for osteochondral lesions of the talus in ankle osteoarthritis: clinical and radiological outcomes at 36 months
Authors: Roberto Buda
Francesco Castagnini
Marco Cavallo
Laura Ramponi
Francesca Vannini
Sandro Giannini
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2344-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

“One-step” bone marrow-derived cells transplantation and joint debridement for osteochondral lesions of the talus in ankle osteoarthritis: clinical and radiological outcomes at 36 months

Abstract

Introduction

Materials and methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

Level of evidence

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