Bone marrow aspirate concentrate and scaffold for osteochondral lesions of the talus in ankle osteoarthritis: satisfactory clinical outcome at 10 years

2021 ◽  
Author(s):  
Francesca Vannini ◽  
Giuseppe Filardo ◽  
Sante Alessandro Altamura ◽  
Emanuele Di Quattro ◽  
Laura Ramponi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Clinical Outcome ◽  
Bone Marrow Aspirate ◽  
Osteochondral Lesions ◽  
Ankle Osteoarthritis ◽  
Bone Marrow Aspirate Concentrate

scholarly journals Bone marrow aspirate concentrate for the treatment of osteochondral lesions of the talus: a systematic review of outcomes

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Jorge Chahla ◽  
Mark E. Cinque ◽  
Jason M. Schon ◽  
Daniel J. Liechti ◽  
Lauren M. Matheny ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Osteochondral Lesions ◽  
Bone Marrow Aspirate Concentrate

scholarly journals Outcomes Following the Treatment of Talar Osteochondral Lesions with BioCartilage and Bone Marrow Aspirate Concentrate Mixture

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0004
Author(s):  
Ashraf Fansa ◽  
Mark Drakos ◽  
Taylor Cabe ◽  
Peter Fabricant
Keyword(s):  
Bone Marrow ◽  
Patient Reported Outcomes ◽  
Bone Marrow Aspirate ◽  
Statistical Significance ◽  
Osteochondral Lesions ◽  
Foot And Ankle ◽  
Bone Marrow Aspirate Concentrate ◽  
Patient Reported ◽  
The Mean

Category: Arthroscopy Introduction/Purpose: With reported incidence rates ranging from 40% to 70% post ankle sprains and fractures, osteochondral lesions of the talus (OLT) are not uncommon. However, management of such defects remains challenging. Microfracturing is considered the standard treatment for symptomatic OLTs.Larger lesions however typically require more invasive restorative procedures such as autologous osteochondral transplantation. Microfracture results are variable due to the fact that the resulting reparative fibrocartilage is weaker and biomechanically inferior to native hyaline cartilage. In this study, we examine the functional and radiological outcomes following use of a new arthroscopic technique utilizing a mixture of micronized allograft cartilage matrix (BioCartilage) (Arthrex, Naples, FL) soaked in Bone Marrow Aspirate Concentrate (BMAC) to fill OLTs. Methods: Eighty-six consecutive patients treated for OLT using arthroscopic debridement and BioCartilage matrix soaked in BMAC were identified. All patients were treated by a single fellowship-trained sports medicine and foot and ankle surgeon. Functional outcomes were assessed using the Foot and Ankle Outcome Score (FAOS) and Patient-Reported Outcomes Measurement Information System (PROMIS). This information was obtained from a prospective registry at the authors’ institution. Wilcoxon signed rank tests were used to determine statistical significance between pre and postoperative clinical scores. Additionally, an attending radiologist assessed the reparative cartilage morphology on postoperative MRI scans. This was evaluated and scored using a modified magnetic resonance observation of cartilage tissue (MOCART) scoring system. Results: Thirty-one patients (19 Females; 12 Males) with a mean age of 37.8 years (Range 15–54) had a minimum follow-up duration of 12 months and were thus included in this review. Mean follow-up duration was 15.8 months (Range 12 –25.7). The mean patient BMI was 27.4 (Range 19.6 – 39.4), while the average osteochondral lesion size was 85.9 mm2 (Range 35 – 220). The Physical Function domain of the PROMIS score, demonstrated statistically significant change, improving from 40.63 ±8.31 to 48.31 ±10.07 (p=0.02). The Pain Intensity domain also improved significantly from 49.06 ±9.32 to 42.14 ±9.38 (p=0.03). The Pain Interference domain and FAOS scores did improve but not reaching statistical significance. The mean MRI MOCART score was 69 ±13.34 with 13.3 months average follow-up duration. Conclusion: Achieving the longest duration possible of symptom-free functioning postoperatively is the main goal of any cartilage repair procedure. Augmentation of an articular lesion’s infill with BioCartilage and BMAC may help enhance the biomechanical properties of the reparative fibrocartilage construct and its longevity. Our initial findings demonstrate favorable patient-reported outcomes. Moreover, postoperative MRIs demonstrate the majority of the lesions showed either complete or hypertrophic infill, complete or hypertrophic integration, homogenous repair tissue, and isointense signals. Long-term studies prospectively assessing the effectiveness of this technique in maintaining pain-free-function of the ankle joint are warranted.

scholarly journals Short Term Clinical Results of Single Injection Autologous BMAC (Bone Marrow Aspirate Concentrate) As A Therapeutic Option/Tool in Knee Osteoarthritis

2021 ◽  
Author(s):  
Krishna Subramanyam ◽  
Subhadra Poornima ◽  
Satish Kumar ◽  
Qurratulain Hasan
Keyword(s):  
Bone Marrow ◽  
Clinical Outcome ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Single Injection ◽  
Therapeutic Option ◽  
Disease Process ◽  
Joint Disease ◽  
Bone Marrow Aspirate Concentrate ◽  
Grade Ii

Abstract Background: Knee Osteoarthritis (KOA) is a common degenerative joint disease characterized by loss of articular cartilage, osteophyte formation, resulting in disability and affecting the quality of life. There is no treatment as on today to reverse the progression of KOA. The present available treatments for KOA are palliative. Therefore, there is a need for an alternative treatment modality in the treatment of KOA during the early grades, which should help in not only giving a symptomatic relief but also downturn the disease process. Bone marrow aspirate concentrate (BMAC) has gained a considerable importance change in the management/treatment of KOA in the recent times due to its potential advantages of disease modifying and regeneration capacities. The latest studies on usage of Autologous BMAC injection in KOA showed promising and encouraging results in terms of decrease in the pain, improved knee range of movement, daily activities of living and thus improved expectations for good quality lives. The current study aimed to assess the role of single injection- autologous BMAC as a therapeutic option in the treatment of KOA and evaluate the functional and clinical outcome of KL grade II&III patients.Methods: One Hundred and thirty-two patients with KOA (KL grade II&III) were included in the study as per the inclusion criteria. Autologous Bone marrow aspiration was done and the separation was done using density gradient centrifugation and final aspirate was injected into the knee joint. Results: The clinical outcomes of the patients were evaluated at different time points both objectively [Visual Analogue Scale (VAS) & WOMAC (Western Ontario Mac Master Universities Score)] and subjectively (radiographs & MRI) and the follow up was done for a period of one year. At the end of the study period, BMAC therapy showed promising results with encouraging clinical outcome.Conclusion:BMAC therapy has more potential with satisfactory, efficient and durable results in KOA. BMAC/mononuclear cells with enriched stem cell therapy can be an alternative therapy as an early intervention option for knee osteoarthritis.

scholarly journals Bone Marrow Aspirate Concentrate and Microfracture Technique for Talar Osteochondral Lesions of the Ankle

2018 ◽  
Vol 7 (4) ◽  
pp. e391-e396 ◽  
Author(s):  
Evelyn P. Murphy ◽  
Christopher Fenelon ◽  
Niall P. McGoldrick ◽  
Stephen R. Kearns
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Osteochondral Lesions ◽  
Bone Marrow Aspirate Concentrate

Comparison of Functional and Radiographic Outcomes of Talar Osteochondral Lesions Repaired With Micronized Allogenic Cartilage Extracellular Matrix and Bone Marrow Aspirate Concentrate vs Microfracture

2021 ◽  
pp. 107110072098326
Author(s):  
Mark C. Drakos ◽  
Stephanie K. Eble ◽  
Taylor N. Cabe ◽  
Karan Patel ◽  
Oliver B. Hansen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Extracellular Matrix ◽  
Magnetic Resonance ◽  
Bone Marrow Aspirate ◽  
Osteochondral Lesions ◽  
Measurement Information ◽  
Bone Marrow Aspirate Concentrate ◽  
Radiographic Outcomes ◽  
Patient Reported ◽  
Outcome Scores

Background: Microfracture (MF) has been used historically to treat osteochondral lesions of the talus (OLTs), with favorable outcomes reported in approximately 80% to 85% of cases. However, MF repairs have been shown to degrade over time at long-term follow-up, suggesting that further study into optimal OLT treatment is warranted. The use of adjuvant extracellular matrix with bone marrow aspirate concentrate (ECM-BMAC) has not been extensively evaluated in the literature. We present a comparison of patient-reported and radiographic outcomes following ECM-BMAC repair vs traditional MF. Methods: Patients who underwent MF (n = 67) or ECM-BMAC (n = 62) treatment for an OLT were identified and their charts were retrospectively reviewed. Postoperative magnetic resonance imaging (MRI) was evaluated and patient-reported outcome scores, either Foot and Ankle Outcome Scores (FAOS) or Patient-Reported Measurement Information System (PROMIS) scores, were collected. MRIs were scored by a radiologist, fellowship trained in musculoskeletal radiology, using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) system. Radiographic and clinical outcomes were compared between groups. Results: On average, patients treated with ECM-BMAC demonstrated a higher total MOCART score compared to the MF group (73 ± SD 11.5 vs 54.0 ± 24.1; P = .0015). ECM-BMAC patients also had significantly better scores for the Infill, Integration, and Signal MOCART subcategories. Last, patients treated with ECM-BMAC had a lower rate of revision compared to those treated with MF (4.8% vs 20.9%; P = .007). FAOS scores were compared between groups, with no significant differences observed. Conclusion: When comparing outcomes between patients treated for an OLT with ECM-BMAC vs traditional MF, we observed superior MRI results for ECM-BMAC patients. The rate of revision surgery was higher for MF patients, although patient-reported outcomes were similar between groups. The use of ECM-BMAC as an adjuvant therapy in the treatment of OLTs may result in improved reparative tissue when compared to MF. Level of Evidence: Level III, comparative series.

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