Podium Presentation Biomaterials and Scaffolds

24.2.10 - 1 Year Results of a Prospective, Randomized, Controlled Study After Repair of OCLs of the Talus Comparing 3 Reconstructive Options

Presentation Topic
Biomaterials and Scaffolds
Date
15.04.2022
Lecture Time
12:21 - 12:30
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • M. Walcher (Würzburg, DE)
Authors
  • M. Walcher (Würzburg, DE)
  • L. Seefried (Würburg, DE)
  • L. Deckert (Pforzheim, DE)
  • M. Gesslein (Nürnberg, DE)
  • H. Bail (Nürnberg, DE)
Disclosure
M. Walcher, Geistlich biomaterials Grant Research Support M. Walcher, arthro kinetics Biotechnology Grant Research Support

Abstract

Purpose

Osteochondral lesions of the talus are frequent. Microfracture has been a long-established treatment option, but there are questions as to its durability. There are various augmentation techniques available that are intended to overcome the limitations of microfracture as a treatment for OLT. However, there is limited data that has directly compared the effectiveness of treatment options. Therefore, we undertook a prospective, randomized, controlled clinical trial to compare the outcomes among 3 different surgical techniques for the treatment of OLT

Methods and Materials

64 patients were prospectively randomized to 1 of 3 groups: microfracture alone (n = 21), microfracture with a collagen I/III membrane (n = 20) or microfracture with a collagen matrix (n = 23). Patients were evaluated pre-operatively, 3 months, 6 months and 12 months postoperatively. PROMs were the American Orthopaedic Foot and Ankle Society (AOFAS) score, VAS score, Tegner score, and SF36. The MOCART score was used to assess cartilage regeneration.

Results

Results: The mean age of the patients was 39.1±13.8 years, with no significant difference between the 3 groups. A chi-square test showed no difference in male-female distribution between the 3 groups. At the 12-month follow-up, there was no difference in the AOFAS when compared between groups. The scores were 82.7±15.6 for the collagen I/III group, 83.5±12.3 for the acellular membrane and 84.1±12.9 for the microfracture alone group. Similar statistical results, showing no difference between groups, was also noted for the Tegner, VAS, SF-36 and MOCART scores.

Conclusion

Discussion: Consistent with previously published data, there does not appear to be a short-term difference in either PROMs or MOCART scores when compared between surgical techniques. Importantly, all 3 surgical techniques were one-step procedures, as opposed to autologous chondrocyte transplantation, while avoiding donor site morbidity that is seen with osteochondral autograft transplantation. These results, however, are short-term and a longer follow-up is planned.

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