P187 - Early results of Complete Cartilage Regeneration (CCR) technique for Talar Osteo-Chondral defect (OCD)
Abstract
Purpose
To evaluate the clinical outcome following a new surgical technique for patients with a talar OCDs.
Methods and Materials
Bone marrow aspirate (35mls) is harvested from the iliac spine of the pelvis. This is spun down into a Mesenchymal Stem Cell (MSC) rich concentrate. Using a dual barrel syringe, the concentrate is mixed with Thrombin in one barrel and Hyaluronic acid with Fibrinogen in another. The syringe mixture is then injected into the prepared defect, to form a MSC rich patch.
Results
Sixty-two patients were treated from 2015 till 2018, and follow up scores were prospectively available for 51 patients. The mean follow up time was 1.1 year (range 0.3-3.3 years). The means of each of the three components of the MOxFQ significantly improved between baseline and 1 year (p<0.001 for each component), whereas no evidence for further change was found from year 1 onwards (p=0.67, p=0.66 and p=0.11 for walking, pain and social function, see also Table 1. EQ-5D Index and VAS score also improved during the same follow up period. There were no complications locally or systemically in any of the patients with this technique.
| Component | Baseline | 1 Year | 2 Year | Diff. baseline-1 year | Diff. 1 Year- 2 Year |
|---|---|---|---|---|---|
| Walking | 71 (68-75) | 33 (25-43) | 35 (24-45) | 38 (26-49) | -2 (-13-11) |
| Pain | 64 (61-68) | 34 (27-42) | 36 (25-45) | 30 (20-39) | -2 (-12-10) |
| Social functioning | 57 (53-61) | 20 (13-28) | 27 (19-34) | 36 (27-46) | -7 (-15-2) |
Conclusion
At an average follow-up of 1 year the use of CCR technique has shown it to be a clinically effective treatment for talar OCDs. Further work will be undertaken to monitor the longer term outcomes and their comparison to other techniques in this cohort of patients.
