Bone marrow aspirate concentrate (BMAC) seeded in situ onto a scaffold provided satisfactory results for the treatment of osteochondral lesions of the talus (OLT). However, no studies evaluated the relationship between the therapeutic effect of this arthroscopic technique and the number of mononuclear cells (MNCs) in BMAC. Aim of this study was to investigate the impact of the number of cells in BMAC on the clinical outcome of a bone marrow derived cell transplantation (BMDCT) technique in patients with OLTs.
A total of 143 consecutive patients with OLTs (area >1.5 cm2) were treated with a BMDCT technique: BMAC was harvested from the posterior iliac crest and seeded onto a hyaluronic acid membrane. Patients were evaluated with the AOFAS score before the treatment and up to 60 months of follow-up. For 100 of these patients, 2 ml of bone marrow aspirate (BMA) and 2 ml of BMAC was collected and used for MNCs count. A statistical analysis was performed to investigate the influence of the number of MNCs on clinical outcomes.
Mean AOFAS score improved from 58.3 ± 13.4 preoperatively to 87.4 ± 15.9 at 60 months (p < 0.0005). BMA from the iliac crest contained a mean of 27.7 ± 8.9 x 103/μL MNCs and the BMAC contained 151.6 ± 56.4 x 103/μL MNCs. Higher number of MNCs in BMA positively correlated with AOFAS score at 36 months of follow-up (Rho = 0.275, p = 0.021). Higher number of MNCs in BMAC positively correlated with AOFAS score at 60 months of follow-up (Rho = 0.509, p = 0.007).
One-step BMDCT obtained positive results up to 60 months of follow-up in patients with OLTs. The number of MNCs in BMAC seems to positively influence the clinical outcome obtained with this arthroscopic procedure.