Purpose

Our study is a multicentric trial with the presentation of our series including 91 osteochondral lesions of the ankle joint. We try to determine the clinical and radiographic efficacy of three different scaffolds as BST-CarGel, Hyalofast and MaioRegen in patients with focal osteochondral lesion bigger than 1.5 cm² of the ankle joint.

Methods and Materials

Clinical data of 91 patients arthroscopically treated using either BST-CarGel scaffold (23 patients, Group 1) or Hyalofast scaffold (54 patients, Group 2) or MaioRegen scaffold (14 patients, Group 3) in combination with microfracture were retrospectively evaluated. Patients had ankle arthroscopy surgery due to osteochondral lesion of talus with our standard technique through standard lateral and medial portals.

After surgery neutral short leg cast was used for two weeks, patients were encouraged to partial weight bear at 4^th week and started our standard physiotherapy protocol. T2 relaxation time with use of standardized twelve-month posttreatment MRI scans and 12^th month AOFAS scores were calculated.

Results

Patient baseline characteristics were similar in the three groups. 91 patients with a mean age of 39.86 years (18-61) were included to this study. 36 (39.6 %) female and 55 (60.4 %) male were analyzed. Blinded quantitative magnetic resonance imaging analysis demonstrated that statistical superiority for lesion filling and more hyaline cartilage-like T2 values. Mean preoperative AOFAS score in whole groups is 70.13±9.52 (40-86) and mean postoperative AOFAS score is 82.98±8.52 (63-99); and improvement at clinical benefit is significant (p < 0.001). According to the between group analyze, improvement at the Hyalofast group was better than the other groups through the AOFAS scores.

Conclusion

At twelve months, scafold treatment for ankle osteochondral lesions resulted in greater lesion filling and superior repair tissue quality. Clinical benefit was better at hyalofast group although results were equivalent at magnetic resonance imaging in whole groups.