Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study
Introduction: Many procedures are available to manage cartilage defects of the talus, including microfracturing (MFx) and Autologous Matrix Induced Chondrogenesis (AMIC). Whether AMIC or MFx are equivalent for borderline sized defects of the talar shoulder is unclear. Thus, the present study compare...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-03-01
|
| Series: | Life |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-1729/11/3/244 |
| _version_ | 1827697644357550080 |
|---|---|
| author | Filippo Migliorini Jörg Eschweiler Nicola Maffulli Hanno Schenker Arne Driessen Björn Rath Markus Tingart |
| author_facet | Filippo Migliorini Jörg Eschweiler Nicola Maffulli Hanno Schenker Arne Driessen Björn Rath Markus Tingart |
| author_sort | Filippo Migliorini |
| collection | DOAJ |
| description | Introduction: Many procedures are available to manage cartilage defects of the talus, including microfracturing (MFx) and Autologous Matrix Induced Chondrogenesis (AMIC). Whether AMIC or MFx are equivalent for borderline sized defects of the talar shoulder is unclear. Thus, the present study compared the efficacy of primary isolated AMIC versus MFx for borderline sized focal unipolar chondral defects of the talar shoulder at midterm follow-up. Methods: Patients undergoing primary isolated AMIC or MFx for focal unipolar borderline sized chondral defects of the talar shoulder were recruited prospectively. For those patients who underwent AMIC, a type I/III collagen resorbable membrane was used. The outcomes of interest were: Visual Analogic Scale (VAS), Tegner Activity Scale, American Orthopedic Foot and Ankle Score (AOFAS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) was assessed by a blinded radiologist, who had not been involved in the clinical management of the patients. Data concerning complication rate and additional procedures were also collected. Results: The mean follow-up was 43.5 months. The mean age of the 70 patients at operation was 32.0 years, with a mean defect size of 2.7 cm<sup>2</sup>. The mean length of hospitalization was shorter in the MFx cohort (<i>p</i> = 0.01). No difference was found between the two cohorts in terms of length of prior surgery symptoms and follow-up, mean age and BMI, sex and side, and defect size. At a mean follow-up of 43.5 months, the AOFAS (<i>p</i> = 0.03), VAS (<i>p</i> = 0.003), and Tegner (<i>p</i> = 0.01) scores were greater in the AMIC group. No difference was found in the MOCART score (<i>p</i> = 0.08). The AMIC group evidenced lower rates of reoperation (<i>p</i> = 0.008) and failure (<i>p</i> = 0.003). Conclusion: At midterm follow-up, AMIC provides better results compared to MFx. |
| first_indexed | 2024-03-10T13:12:49Z |
| format | Article |
| id | doaj.art-ae727f4648eb43759e6e14df41068b15 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T13:12:49Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-ae727f4648eb43759e6e14df41068b152023-11-21T10:38:38ZengMDPI AGLife2075-17292021-03-0111324410.3390/life11030244Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort StudyFilippo Migliorini0Jörg Eschweiler1Nicola Maffulli2Hanno Schenker3Arne Driessen4Björn Rath5Markus Tingart6Department of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanySchool of Pharmacy and Bioengineering, Keele University School of Medicine, Staffordshire ST4 7QB, UKDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyIntroduction: Many procedures are available to manage cartilage defects of the talus, including microfracturing (MFx) and Autologous Matrix Induced Chondrogenesis (AMIC). Whether AMIC or MFx are equivalent for borderline sized defects of the talar shoulder is unclear. Thus, the present study compared the efficacy of primary isolated AMIC versus MFx for borderline sized focal unipolar chondral defects of the talar shoulder at midterm follow-up. Methods: Patients undergoing primary isolated AMIC or MFx for focal unipolar borderline sized chondral defects of the talar shoulder were recruited prospectively. For those patients who underwent AMIC, a type I/III collagen resorbable membrane was used. The outcomes of interest were: Visual Analogic Scale (VAS), Tegner Activity Scale, American Orthopedic Foot and Ankle Score (AOFAS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) was assessed by a blinded radiologist, who had not been involved in the clinical management of the patients. Data concerning complication rate and additional procedures were also collected. Results: The mean follow-up was 43.5 months. The mean age of the 70 patients at operation was 32.0 years, with a mean defect size of 2.7 cm<sup>2</sup>. The mean length of hospitalization was shorter in the MFx cohort (<i>p</i> = 0.01). No difference was found between the two cohorts in terms of length of prior surgery symptoms and follow-up, mean age and BMI, sex and side, and defect size. At a mean follow-up of 43.5 months, the AOFAS (<i>p</i> = 0.03), VAS (<i>p</i> = 0.003), and Tegner (<i>p</i> = 0.01) scores were greater in the AMIC group. No difference was found in the MOCART score (<i>p</i> = 0.08). The AMIC group evidenced lower rates of reoperation (<i>p</i> = 0.008) and failure (<i>p</i> = 0.003). Conclusion: At midterm follow-up, AMIC provides better results compared to MFx.https://www.mdpi.com/2075-1729/11/3/244talusanklechondral defectautologous matrix induced chondrogenesisAMICmicrofractures |
| spellingShingle | Filippo Migliorini Jörg Eschweiler Nicola Maffulli Hanno Schenker Arne Driessen Björn Rath Markus Tingart Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study Life talus ankle chondral defect autologous matrix induced chondrogenesis AMIC microfractures |
| title | Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study |
| title_full | Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study |
| title_fullStr | Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study |
| title_full_unstemmed | Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study |
| title_short | Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study |
| title_sort | autologous matrix induced chondrogenesis amic compared to microfractures for chondral defects of the talar shoulder a five year follow up prospective cohort study |
| topic | talus ankle chondral defect autologous matrix induced chondrogenesis AMIC microfractures |
| url | https://www.mdpi.com/2075-1729/11/3/244 |
| work_keys_str_mv | AT filippomigliorini autologousmatrixinducedchondrogenesisamiccomparedtomicrofracturesforchondraldefectsofthetalarshoulderafiveyearfollowupprospectivecohortstudy AT jorgeschweiler autologousmatrixinducedchondrogenesisamiccomparedtomicrofracturesforchondraldefectsofthetalarshoulderafiveyearfollowupprospectivecohortstudy AT nicolamaffulli autologousmatrixinducedchondrogenesisamiccomparedtomicrofracturesforchondraldefectsofthetalarshoulderafiveyearfollowupprospectivecohortstudy AT hannoschenker autologousmatrixinducedchondrogenesisamiccomparedtomicrofracturesforchondraldefectsofthetalarshoulderafiveyearfollowupprospectivecohortstudy AT arnedriessen autologousmatrixinducedchondrogenesisamiccomparedtomicrofracturesforchondraldefectsofthetalarshoulderafiveyearfollowupprospectivecohortstudy AT bjornrath autologousmatrixinducedchondrogenesisamiccomparedtomicrofracturesforchondraldefectsofthetalarshoulderafiveyearfollowupprospectivecohortstudy AT markustingart autologousmatrixinducedchondrogenesisamiccomparedtomicrofracturesforchondraldefectsofthetalarshoulderafiveyearfollowupprospectivecohortstudy |