Potsdam 3 Free Papers
Session Type
Free Papers
Date
15.04.2022
Time
11:00 - 12:30
Room
Potsdam 3
Moderators
  • S. Fickert (Straubing, DE)
  • M. Ezechieli (Salzkotten, DE)
CME Evaluation
Podium Presentation Platelet Rich Plasma and Growth factors

24.2.1 - Comparison of Safety and Efficacy Between Autologous PRP and Cordonal PRP in the Treatment of Hip OA

Presentation Topic
Platelet Rich Plasma and Growth factors
Date
15.04.2022
Lecture Time
11:00 - 11:09
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • A. Mazzotta (Bologna, IT)
Authors
  • A. Mazzotta (Bologna, IT)
  • E. Pennello (Bologna, IT)
  • C. Stagni (Bologna, IT)
  • N. Del Piccolo (Bologna, IT)
  • A. Boffa (Bologna, IT)
  • G. Filardo (Bologna, IT)
  • D. Dallari (Bologna, IT)
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

There is a growing interest on regenerative medicine and platelet-rich plasma (PRP), with the aim of finding a conservative alternative to prosthetic surgery in hip osteoarthritis (OA). Currently, no study is available in the literature evaluating the treatment of OA with cordonal PRP (PRP-C) injections. The aim of this study was to verify the efficacy and safety of PRP-C injections in comparison with autologous PRP (PRP-A) in hip OA treatment.

Methods and Materials

After ethics committee approval, 100 patients under the age of 65 (mean 48 years old) and suffering from symptomatic unilateral hip OA of medium degree (1-3 Tonnis), were consecutively treated with 3 weekly ultrasound-guided PRP injections at our institution. Patients were divided into two groups: 50 patients treated with PRP-A, 50 patients with PRP-C. Clinical evaluations before the treatment, and after 2, 6, and 12 months were performed by HHS, WOMAC and VAS scores.

Results

Two patients in PRP-C group were lost at follow-up, 1 patient of the same group was excluded as screening failure (Tonnis 4). No major adverse events have been recorded during follow-up. Overall, the improvement was limited with both treatments. Statistical analysis revealed a significant decrease in VAS (p = 0.031) and a significant improvement in HHS (p = 0.011) at 2 months with PRP-C. The clinical outcome was influenced by the Tonnis degree, with a scarce benefit in the more advanced OA cases.

Conclusion

PRP-C has shown an excellent safety profile, although it offers only a modest and short-term clinical improvement. The results are influenced by the degree of OA. Further studies with larger case series are needed to confirm the most suitable indications and potential of these biological injective approaches.

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Podium Presentation Clinical Outcome

24.2.2 - Labral Tear Management in Patients Aged 40 Years and Older Undergoing Primary Hip Arthroscopy

Presentation Topic
Clinical Outcome
Date
15.04.2022
Lecture Time
11:09 - 11:18
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • P. Padilla (Des Plaines, US)
Authors
  • B. Domb (Des Plaines, US)
  • D. Maldonado (Des Plaines, US)
  • V. Ouyang (Des Plaines, US)
  • J. Owens (Des Plaines, US)
  • A. Jimenez (Des Plaines, US)
  • B. Saks (Des Plaines, US)
  • P. Sabetian (Des Plaines, US)
  • A. Lall (Des Plaines, US)
  • T. Harris (Des Plaines, US)
  • P. Padilla (Des Plaines, US)
Disclosure
Financial interests: Amplitude, Arthrex, ATI, Breg, DJO Global, Kauffman Foundation, MAKO Surgical, Medacta, Medwest, Orthomerica, Pacira Pharmaceuticals, Stryker Affiliations: American Hip Institute, Hinsdale Orthopaedics, North Shore Surgical Suites,

Abstract

Purpose

To report minimum two-year patient-reported outcome (PRO) scores, survivorship, and secondary surgeries, in patients aged ≥ 40 years who underwent primary hip arthroscopy with labral reconstruction compared to a propensity-matched primary labral repair group.

Methods and Materials

Data were prospectively collected and retrospectively reviewed for patients who underwent a primary hip arthroscopy for femoroacetabular impingement syndrome from January 2014 to June 2018. Patients aged ≥ 40 years who underwent a labral reconstruction or a labral repair and had preoperative and minimum two-year PROs for the modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), and visual analog scale (VAS) for pain were included. Patients with prior ipsilateral hip conditions and surgery, Tonnis grade > 1, hip dysplasia, or worker’s compensation status were excluded. Patients in the reconstruction group were propensity-matched 1:2 to patients in the repair group based on age, sex, and body mass index. Secondary surgeries and the achievement of the minimal clinically importance difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement (MOI) were recorded.

Results

Fifty-three and 106 hips were included in the labral reconstruction and repair groups, respectively. The average follow-up time was 37.6 months. The average age for the reconstruction and repair groups were 48.01 ± 5.4 years and 48.61 ± 6.0 years, respectively. Both groups achieved significant improvements in all PROs with similar achievements of MCID, PASS, and MOI. Both groups showed comparable secondary surgeries rates.

Conclusion

Patients aged 40 years and older who received primary labral repair and primary labral reconstruction, achieved similar significant improvements in all PROs, VAS pain, and patient satisfaction at minimum two-year follow-up, with comparable rates of secondary surgeries and achieving MCID, PASS, and MOI. Based on these findings, labral repair remains the gold standard treatment for viable labrum in this population group, while reconstruction is a useful alternative for irreparable labrum.

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Podium Presentation Cartilage Imaging and Functional Testing

24.2.3 - dGEMRIC Analysis of Neoacetabular and Acetabular Cartilage of Patients With Developmental Dysplasia of the Hip

Presentation Topic
Cartilage Imaging and Functional Testing
Date
15.04.2022
Lecture Time
11:18 - 11:27
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • T. Duvančić (Zagreb, HR)
Authors
  • T. Duvančić (Zagreb, HR)
  • M. Plečko (Zagreb, HR)
  • A. Vukasović Barišić (Bjelovar, HR)
  • I. Bohaček (Zagreb, HR)
  • D. Delimar (Zagreb, HR)
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

The aim of our study was to investigate whether mechanical pressure plays an important role in cartilage degeneration in patients with developmental dysplasia of the hip. Here we compare glycosaminoglycan (GAG) content of neoacetabular cartilage (region subjected to mechanical pressure) and acetabular cartilage (region that is under no pressure) of patients with secondary hip osteoarthritis induced by developmental dysplasia of the hip (DDH), using delayed-gadolinium enhanced MRI of cartilage (dGEMRIC).

Methods and Materials

Samples of osteochondral unit were obtained from neoacetabular (NA) and acetabular (Ac) region of the hip from patients (N=10) with DDH-induced secondary hip osteoarthritis undergoing total hip arthroplasty, with a 10 mm diameter cylindrical chisel. Samples were scanned on a 7.0T micro-MRI machine (BioSpec 70/20 USR, Bruker Biospin, Germany) immediately following the surgery. T1 relaxometry was performed. Samples were then immersed in 0.5mM gadolinium solution for 16h and scanned using dGEMRIC protocol. T1 relaxation times before (T1preGd) and after gadolinium application (T1Gd) were calculated. ΔR was calculated as (1/T1Gd -1/T1preGd). Results obtained from different anatomical regions were compared using a t-test, with a significance level set at 0.05.

Results

Mean T1 relaxation times after gadolinium application of Ac and NA were 609.671 ms and 552.800 ms, respectively. Calculated ΔR values of Ac and NA were 0.00114 ms-1 and 0.00141 ms-1. Statistical analysis showed no significant differences between different anatomical regions.

Conclusion

No significant difference was found between GAG content of neoacetabular and acetabular cartilage of DDH patients, indicating that no weight bearing does not have a positive effect on GAG content of acetabular cartilage in DDH. However, both T1 relaxation times after gadolinium application and ΔR values show that neoacetabular cartilage tends to be more degenerated. To fully understand the extent of tissue damage caused by DDH, more research needs to be done, with the emphasis on neoacetabular region.

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Podium Presentation Clinical Outcome

24.2.4 - Minimum 10-Year Follow-Up Outcomes and Survivorship Following Primary Hip Arthroscopy With Acetabular Microfracture

Presentation Topic
Clinical Outcome
Date
15.04.2022
Lecture Time
11:27 - 11:36
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • P. Padilla (Des Plaines, US)
Authors
  • B. Domb (Des Plaines, US)
  • D. Maldonado (Des Plaines, US)
  • M. Lee (Des Plaines, US)
  • A. Jimenez (Des Plaines, US)
  • A. Lall (Des Plaines, US)
  • T. Harris (Des Plaines, US)
  • P. Padilla (Des Plaines, US)
  • P. Sabetian (Des Plaines, US)
Disclosure
Financial interests: Amplitude, Arthrex, ATI, Breg, DJO Global, Kauffman Foundation, MAKO Surgical, Medacta, Medwest, Orthomerica, Pacira Pharmaceuticals, Stryker Affiliations: American Hip Institute, Hinsdale Orthopaedics, North Shore Surgical Suites,

Abstract

Purpose

To report minimum 10-year follow-up patient-reported outcomes (PROS) in patients following primary hip arthroscopy in the setting of femoroacetabular impingement syndrome with acetabular microfracture, and 2) to report the survivorship, defined as non-conversion to total hip arthroplasty (THA) within the same period.

Methods and Materials

Data was prospectively collected and retrospectively analyzed on all patients who underwent a primary hip arthroscopy and received an acetabular microfracture between May 2009 and January 2011 and included in this study. Eligible patients completed preoperative patient-reported outcomes (PROS) questionnaires for the Modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), the Hip Outcome Score – Sport-Specific Subscale (HOS-SSS), and the visual analog scale (VAS) for pain. Patients were excluded from this study if they had previous ipsilateral hip surgery, Tönnis osteoarthritis grade > 1, or previous hip conditions. The demographics, intraoperative findings, surgical procedures, PROs, and secondary surgeries were analyzed.

Results

25 hips were included in the study. There were 10 hips (43.5%) from males and 13 hips (56.5%) from females. The average patient age at the time of surgery was 43.3 years ± 11.1 (25.5 – 65.6), and the follow-up time was 123.9 ± 2.3 months (120.0 – 128.1). All patients on average experienced significantly improvement between preoperative and postoperative PROs in the mHHS (P < 0.001), NAHS (P < 0.001), HOS-SSS (P = 0.004), and VAS for pain (P < 0.001). In total, 65.2% of the patients did not require conversion to THA.

Conclusion

Significant improvement in all PROs and survivorship over 65% were obtained following acetabular microfracture for the management of focal and full-thickness cartilage lesions in primary hip arthroscopy. Based on the results, acetabular microfracture seems to be a feasible and valid alternative for severe and focal cartilage defects.

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Podium Presentation Clinical Outcome

24.2.5 - Athletes Given Capsular Repair Have Successful Outcomes: A Propensity-Matched Analysis With Minimum 2-Year Follow-Up

Presentation Topic
Clinical Outcome
Date
15.04.2022
Lecture Time
11:36 - 11:45
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • P. Padilla (Des Plaines, US)
Authors
  • A. Jimenez (Des Plaines, US)
  • B. Domb (Des Plaines, US)
  • M. Lee (Des Plaines, US)
  • D. Radwanski (Des Plaines, US)
  • J. Owens (Des Plaines, US)
  • B. Saks (Des Plaines, US)
  • D. Maldonado (Des Plaines, US)
  • A. Lall (Des Plaines, US)
  • T. Harris (Des Plaines, US)
  • P. Sabetian (Des Plaines, US)
  • P. Padilla (Des Plaines, US)
Disclosure
Financial interests: Amplitude, Arthrex, ATI, Breg, DJO Global, Kauffman Foundation, MAKO Surgical, Medacta, Medwest, Orthomerica, Pacira Pharmaceuticals, Stryker Affiliations: American Hip Institute, Hinsdale Orthopaedics, North Shore Surgical Suites,

Abstract

Purpose

To compare minimum 2-year patient reported outcome scores (PROs) and return to sport (RTS) between high-level athletes who undergo primary hip arthroscopy with a capsular repair and high-level athletes undergoing primary hip arthroscopy with an unrepaired interportal capsulotomy.

Methods and Materials

Data on all professional, collegiate, and high-school athletes who underwent primary hip arthroscopy between February 2012 and December 2018 were collected. Athletes were divided into 2 groups based on whether they received a capsular repair (R) or an unrepaired interportal capsulotomy (UR). Minimum 2-year PROs were collected for the Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and RTS status. R athletes were propensity-score matched to UR athletes for comparison.

Results

A total of 53 UR athletes (53 hips) with an average follow-up time of 36.5 ± 10.2 months were propensity-score matched to 84 R athletes (84 hips) with an average follow-up time of 41.3 ± 9.4 months. R athletes demonstrated significantly greater magnitude of improvement from preoperative to minimum 2-year postoperative scores for NAHS (P = 0.01), HOS-SSS (P = 0.001), and VAS (P = 0.01). Further, R athletes demonstrated significantly higher rates of achieving MCID for NAHS (73.8% vs 54.7%, P = 0.034) and HOS-SSS (65.5% vs 37.7%, P = 0.003) compared to UR athletes. RTS rates were higher in R athletes compared to the UR athletes, but this did not reach statistical significance (80.6% vs 65.9%, P = 0.170).

athlete capsule.flowchart.pngathlete capsule.sports.png

Conclusion

High-level athletes who undergo primary hip arthroscopy and capsular repair demonstrated significantly greater magnitude of improvement in PROs (NAHS, HOS-SSS, and VAS) compared to a control group athletes with an unrepaired interportal capsulotomy.

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Podium Presentation Others

24.2.6 - Return to Driving Following Hip Arthroscopy – A Systematic Review and Meta-Analysis.

Presentation Topic
Others
Date
15.04.2022
Lecture Time
11:45 - 11:54
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • R. Assaf (Be'er Ya'akov, IL)
Authors
  • R. Assaf (Be'er Ya'akov, IL)
  • I. Mitchnik (Be'er Ya'akov, IL)
  • Y. Beer (Be'er Ya'akov, IL)
  • G. Agar (Tel Aviv, IL)
  • D. Lindner (Be'er Ya'akov, IL)
  • R. Gilat (Be'er Ya'akov, IL)
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

One of the first questions patients ask their physician after orthopedic surgery is when they can safely resume driving. Hip arthroscopy is an increasingly common procedure, however recommendations for safely returning to drive after hip arthroscopy are controversial and vary among surgeons.

The purpose of this article is to systematically review and analyze the current available evidence on the optimal time to safely return to drive after hip arthroscopy.

Methods and Materials

A systematic review and meta-analysis were performed in accordance with the PRISMA guidelines. Two authors independently conducted a literature search throughout August 2021 using the following databases: PubMed, Google Scholar, Embase, and Cochrane. All included articles used brake reaction time (BRT) as an observer-reported outcome measure. A meta-analysis was performed to compare pre- and postoperative BRT values.

Results

Five articles met the inclusion criteria. Included studies evaluated safety to return to drive after hip arthroscopy in a total of 160 patients. Of these, 142 patients were treated for femoroacetabular impingement (FAI) and 18 patients undergone other hip arthroscopy procedures. Mean weighted age was 33.7±9.0 years, 47.5% females, with the right hip affected in 71.2%. Preoperative range of BRT was 566-1960ms. Postoperative BRT range at 1-2 weeks was 567-1,840ms, and at 3-12 weeks 523-1,860ms. Meta-analysis found the studies to be moderately heterogenic (p=0.06) and comparison of pre- and post-operative BRT found no statistically significant differences in BRT between the preoperative period and at 2, 4, 6, and 8 weeks postoperatively.

Conclusion

Return to driving is likely safe as early as two to four weeks following hip arthroscopy, as driving performance returns to the preoperative level. Further high-quality studies are needed to assess alternative clinical tests for the evaluation of driving performance, postoperative incidence and severity of motor vehicle accidents and the effect of other factors such as laterality, weight-bearing restrictions, and manual vs automatic transmission.

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Podium Presentation Cartilage /Cell Transplantation

24.2.7 - Minced Cartilage Procedure for One-Stage Arthroscopic Repair of Chondral Defects in the Hip Joint

Presentation Topic
Cartilage /Cell Transplantation
Date
15.04.2022
Lecture Time
11:54 - 12:03
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • D. Saris (Rochester, US)
Authors
  • M. Husen (Rochester, US)
  • J. Ford (Rochester, US)
  • A. Dietz (Rochester, US)
  • A. Krych (Rochester, US)
  • D. Saris (Rochester, US)
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

To (1) validate a harvesting technique using arthroscopic shaver to collect articular cartilage from the femoral head and to (2) compare the chondron yield and chondron viability to a manual mincing method and a device assisted mincing procedure.

Methods and Materials

Femoral heads were collected from patients with avascular necrosis of the femoral head who underwent total hip arthroplasty (THA) and processed in the laboratory. A 4.0 mm arthroscopic shaver with an attached chondral fragment capture device (GraftNet) was used to harvest the chondral surface from the area of the non-weight bearing regions of the femoral head. The cells were filtered and chondrocytes were isolated by enzymatic digestion. Cells were counted and stained with a live-dead stain and Safranin-O.

Results

16 cartilage samples were processed in total. 12 samples underwent manual processing (surgical removal of cartilage from bone by scalpel, manual mincing with scalpel or mincing device) and 4 samples were retrieved with a 4.0 mm arthroscopic shaver. The different methods produced cartilage particulate of significantly different sizes. Manual mincing with a scalpel or mincing device resulted in larger particles than shaver harvest. Cell yield and viability were comparable between the groups.

figure 1.jpg

Figure 1. Chondron cluster with typical nuclei and extracellular matrix in an arthroscopic shaver sample

asis 1 intact chondrons.jpg

Figure 2. 4 chondrons in an arthroscopic shaver sample

Conclusion

The proposed harvesting method produces a high cell yield and good cell viability with a limited amount of debris. Future studies are needed to focus on short- and long-term outcomes of clinical application, as well as safety and efficacy, and to compare the results with other cartilage restoration and harvesting procedures of the hip.

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Podium Presentation Clinical Outcome

24.2.8 - Does Hip Arthroscopy Prevent Hip Disease Progression? Patients With FAI Treated With Hip Arthroscopy Compared to Patients Without Surgery

Presentation Topic
Clinical Outcome
Date
15.04.2022
Lecture Time
12:03 - 12:12
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • M. Husen (Rochester, US)
Authors
  • M. Husen (Rochester, US)
  • D. Leland (Rochester, US)
  • H. Melugin (Rochester, US)
  • C. Struijk (Rochester, US)
  • R. Hale (Rochester, US)
  • D. Saris (Rochester, US)
  • B. Levy (Rochester, US)
  • A. Krych (Rochester, US)
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

To (1) report clinical outcomes of arthroscopic interventions of the hip with a minimum of 5-year follow-up utilizing a cohort with femoroacetabular impingement syndrome that did not undergo hip arthroscopy, and (2) determine the influence of hip arthroscopy on the progression of osteoarthritis (OA) of the hip.

Methods and Materials

Patients who (1) presented with hip pain and were diagnosed with FAI and (2) had a minimum follow-up time of 5 years were included. Exclusion criteria were periacetabular osteotomy (PAO) performed ipsilaterally and <5 years of follow-up. A total number of 1565 patients were identified. Hip arthroscopy patients were compared to patients that presented with femoroacetabular impingement but did not undergo hip arthroscopy.

Results

A total of 201 patients were evaluated for inclusion study in the surgical group, with 129 patients (64%), comprising 45 men (35%) and 84 women (85%), eligible based on study criteria. A total of 1364 patients were evaluated for inclusion in the non-surgical group, with 1055 patients (77.3%), comprising 333 men (31.6%) and 722 women (68.4%), eligible based on study criteria. At a mean follow up of 8.4 years, 4.7% of patients of the HA group progressed to THA, compared to 4.5% of the non-operative control group. While most of the HA group showed no (21.7%) or mild signs (Tönnis 1: 65.1%) of OA at follow-up, moderate OA (Tönnis 2) was present in 8.5% of patients compared to 17.4% in the group of non-operative treatment.

table 1.png

Table 1. Radiographic Characteristics of all Patients as Determined by Tönnis Grade

Conclusion

At mid-term follow-up, patients treated with hip arthoroscopy had similar rates of radiographic arthritis and progression to hip arthroplasty compared to non-opeatively reated patients.

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Podium Presentation Clinical Outcome

24.2.9 - Influence of the Patient Age on Surgical Outcome of Osteochondral Lesions of the Talus: Data From the German Cartilage Registry

Presentation Topic
Clinical Outcome
Date
15.04.2022
Lecture Time
12:12 - 12:21
Room
Potsdam 3
Session Type
Free Papers
Speaker
  • A. Richter (Hannover, DE)
Authors
  • A. Richter (Hannover, DE)
  • C. Plaass (Hannover, DE)
  • S. Ettinger (Hannover, DE)
  • A. Altemeier (Hannover, DE)
  • C. Becher (Heidelberg, DE)
  • M. Güllmann (Hannover, DE)
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Osteochondral lesions of the talus (OCT) are one of the main causes of ankle pain in young and active patients. The influence of age on the outcomes of treatment of OCT is still controversial. Some studies indicate that there is a negative correlation between clinical results of treated talar OCLs and patient age. Previous trials were mostly limited by a small cohort size and have been conducted in a single center. Registry data are considered more representative for evaluation of clinical results than data obtained in studies and might offer the opportunity to get a closer insight to the outcome of revision surgery.

We evaluated registry data on OCT of the German Cartilage Registry (KnorpelRegister DGOU) with regard to clinical scores and defect size depending on patient age.

Methods and Materials

Data in the German Cartilage Registry have been analyzed for singularly OCT with documented defect size and complete FAOS score after 24 month. Patient population was subdivided into 6 different age groups: <20 years, 20-29 years, 30-39 years, 40-49 years, 50-59 years, ≥ 60 years.

Results

A cohort of 303 patients was identified. Average preoperative FAOS-Pain score was 61,179 (SD 20,385) and postoperative FAOS-Pain score was 78,74 (SD 19,675) leading to an improvement of 17,562 points. The different age groups showed no significant differences in the improvement of FAOS-Pain score with: <20 years: 13,417; 20-29 years: 18,832; 30-39 years: 17,466; 40-49 years: 18,613; 50-59 years: 15,571; ≥ 60 years: 17,747.

Conclusion

Patient age has no impact on the outcome of surgical treatment of singular OCL of the talus. The impact of patient age on defect size and surgical technique has to be further analyzed.

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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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