scholarly journals Cell-free osteochondral scaffolds provide a substantial clinical benefit in the treatment of osteochondral defects at a minimum follow-up of 5 years

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Martina Ricci ◽  
Daniele Tradati ◽  
Alessio Maione ◽  
Francesco Mattia Uboldi ◽  
Eva Usellini ◽  
...  
Keyword(s):  
Osteochondral Lesion ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Activity Level ◽  
Osteochondral Lesions ◽  
Level Of Evidence ◽  
Osteochondral Scaffold ◽  
Level Scale ◽  
Tegner Activity Level

Abstract Purpose The treatment of osteochondral lesions is challenging and no consensus has been established about the best option for restoring both cartilage and subchondral bone. Multilayer collagen-hydroxyapatite scaffolds have shown promising clinical results, but the outcome at a follow-up longer than 5 years still has to be proved. The aim was to evaluate the clinical outcome of patients with a knee isolated osteochondral lesion treated with a biomimetic three-layered scaffold at a minimum 5 years of follow-up. Methods Twenty-nine patients (23 males and 6 females, mean age 31.5 ± 11.4 years) were evaluated retrospectively before surgery, at 1 and 2 years and at last follow-up (FU). Visual Analog Scale (VAS) for pain, International Knee Documentation Committee (IKDC) Subjective Score, Tegner-Lysholm Knee Scoring Scale and Tegner Activity Level Scale were collected. Mean FU was 7.8 ± 2.0 years (min 5.1 - max 11.3). The etiology of the defect was Osteochondritis Dissecans or osteonecrosis (17 vs 12 cases). Results At 12 months FU the IKDC score improved from 51.1 ± 21.7 to 80.1 ± 17.9 (p < 0.01), Tegner Lysholm Score from 59.9 ± 17.3 to 92.5 ± 9.0 (p < 0.01), VAS from 6.1 ± 2.1 to 1.7 ± 2.3 (p < 0.01) and Tegner Activity Level Scale from 1.6 ± 0.5 to 4.9 ± 1.7 (p < 0.01). The results remained stable at 24 months, while at last FU a statistically significant decrease in IKDC, Tegner Lysholm and Tegner Activity Scale was recorded, though not clinically relevant. Patients under 35 achieved statistically better outcomes. Conclusions The use of a cell-free collagen-hydroxyapatite osteochondral scaffold provides substantial clinical benefits in the treatment of knee osteochondral lesions at a minimum follow-up of 5 years, especially in patients younger than 35 years. Level of evidence Level IV.

scholarly journals Cell-Free Osteochondral Scaffold for the Treatment of Focal Articular Cartilage Defects in Early Knee OA: 5 Years’ Follow-Up Results

2019 ◽  
Vol 8 (11) ◽  
pp. 1978 ◽  
Author(s):  
Andrea Sessa ◽  
Luca Andriolo ◽  
Alessandro Di Martino ◽  
Iacopo Romandini ◽  
Roberto De Filippis ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Activity Level ◽  
Cartilage Defects ◽  
Mri Findings ◽  
Clinical Criteria ◽  
Osteochondral Scaffold ◽  
Articular Cartilage Defects

The purpose of this study was to investigate the clinical results at five years’ follow-up of a tri-layered nanostructured biomimetic osteochondral scaffold used for focal articular cartilage defects in patients meeting the criteria of early osteoarthritis (EOA). The study population comprised 22 patients (mean age: 39 years), prospectively assessed before surgery, at 24 and 60 months’ follow-up. Inclusion criteria were: at least two episodes of knee pain for more than 10 days in the last year, Kellgren-Lawrence OA grade 0, I or II and arthroscopic or MRI findings according to the European Society of Sports Traumatology, Knee Surgery & Arthroscopy (ESSKA) criteria. Clinical results demonstrated significant improvement in International Knee Documentation Committee (IKDC) subjective and objective scores and in Tegner score, although activity level never reached the pre-injury level. The complication rate of this study was 8.3%. Two patients underwent re-operation (8.3%), while a comprehensive definition of failure (including both surgical and clinical criteria) identified four failed patients (16.6%) at this mid-term follow-up evaluation. The use of a free-cell osteochondral scaffold represented a safe and valid alternative for the treatment of focal articular cartilage defects in the setting of an EOA, and was able to permit a significant clinical improvement and stable outcome with low complication and failure rates.

scholarly journals An electronic patient-reported outcomes measurement system in paediatric orthopaedics

2019 ◽  
Vol 13 (4) ◽  
pp. 431-437 ◽  
Author(s):  
M. J. Sabatino ◽  
C. V. Gans ◽  
A. J. Zynda ◽  
J. S. Chung ◽  
S. M. Miller ◽  
...  
Keyword(s):  
International Knee Documentation Committee ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Activity Level ◽  
Level Of Evidence ◽  
Assess Patient Satisfaction ◽  
Patient Reported ◽  
Group 2 ◽  
Level Scale ◽  
Tegner Activity Level

Purpose The purpose of the study was to evaluate the reliability, review differences and assess patient satisfaction of electronic patient-reported outcome measures (PROMs) compared with paper PROMs. Methods Participants between 12 and 19 years of age with a knee-related primary complaint were randomized into two groups. Group 1 completed paper PROMs followed by electronic, while Group 2 received the electronic followed by paper. PROMs included the Pediatric International Knee Documentation Committee (Pedi-IKDC), Hospital for Special Surgery (HSS) Pediatric Functional Activity Brief Scale (HSS Pedi-FABS), Tegner Activity Level Scale, Visual Analogue Scale (VAS), PedsQL Teen and a satisfaction survey. Results In all, 87 participants were enrolled with one excluded due to incomplete PROMs. Of the 86 participants, 54 were female and 32 were male with an average age of 14.3 years (12 to 18). A high degree of reliability was found when comparing the paper and electronic versions of the Pedi-IKDC (0.946; p < 0.001), HSS Pedi-FABS (0.923; p < 0.001), PedsQL Teen (0.894; p < 0.001), Tegner Activity Level Scale before injury (0.848; p < 0.001) and the Tegner Activity Level Scale after (0.930; p < 0.001). Differences were noted between the VAS scores, with paper scores being significantly higher than electronic (5.3 versus 4.6; p < 0.001). While not significant, a trend was noted in which electronic PROMs took, overall, less time than paper (10.0 mins versus 11.2 mins; p = 0.096). Of all participants, 69.8% preferred the electronic PROMs, 67.4% felt they were faster, 93.0% stated they would complete forms at home prior to appointments and 91.8% were not concerned about the safety/privacy of electronic forms. Conclusion PROMs captured electronically were reliable when compared with paper. Electronic PROMs may be quicker, will not require manual scoring and are preferred by patients. Level of Evidence II

scholarly journals Multi-layer cell-free scaffolds for osteochondral defects of the knee: a systematic review and meta-analysis of clinical evidence

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Angelo Boffa ◽  
Luca Solaro ◽  
Alberto Poggi ◽  
Luca Andriolo ◽  
Davide Reale ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Sport Activity ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Activity Level ◽  
Osteochondral Lesions ◽  
Osteochondral Defects ◽  
Layer Cell

Abstract Purpose The aim of this study was to analyze the clinical results provided by multi-layer cell-free scaffolds for the treatment of knee osteochondral defects. Methods A systematic review was performed on PubMed, Web of Science, and Cochrane to identify studies evaluating the clinical efficacy of cell-free osteochondral scaffolds for knee lesions. A meta-analysis was performed on articles reporting results of the International Knee Documentation Committee (IKDC) and Tegner scores. The scores were analyzed as improvement from baseline to 1, 2, and ≥ 3 years of follow-up. The modified Coleman Methodology Score was used to assess the study methodology. Results A total of 34 studies (1022 patients) with a mean follow-up of 35 months was included. Only three osteochondral scaffolds have been investigated in clinical trials: while TruFit® has been withdrawn from the market for the questionable results, the analysis of MaioRegen and Agili-C™ provided clinical improvements at 1, 2, and ≥ 3 years of follow-up (all significantly higher than the baseline, p < 0.05), although with a limited recovery of the sport-activity level. A low rate of adverse events and an overall failure rate of 7.0% were observed, but the overall evidence level of the available studies is limited. Conclusions Multi-layer scaffolds may provide clinical benefits for the treatment of knee osteochondral lesions at short- and mid-term follow-up and with a low number of failures, although the sport-activity level obtained seems to be limited. Further research with high-level studies is needed to confirm the role of multi-layer scaffold for the treatment of knee osteochondral lesions.

scholarly journals A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Osteochondral Lesions ◽  
Femoral Head Fracture ◽  
Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

Does Transection of the Superficial MCL During HTO Result in Progressive Valgus Instability?

2021 ◽  
pp. 036354652110591
Author(s):  
Joo-Hwan Kim ◽  
Dong Jin Ryu ◽  
Sung-Sahn Lee ◽  
Seung Pil Jang ◽  
Jae Sung Park ◽  
...  
Keyword(s):  
Case Series ◽  
Preoperative Assessment ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Osteotomy Site ◽  
Tibial Osteotomy ◽  
Level Of Evidence ◽  
Valgus Stress ◽  
Valgus Instability

Background: During high tibial osteotomy (HTO), the superficial medial collateral ligament (sMCL) is cut or released at any degree to expose the osteotomy site and achieve the targeted alignment correction according to the surgeon’s preference. However, it is still unclear whether transection of sMCL increases valgus laxity. Purpose: We aimed to assess the outcomes and safety of sMCL transection, especially focusing on iatrogenic valgus instability. Study Design: Case series; Level of evidence, 4. Methods: Seventy-two patients (89 knees) who underwent medial open wedge HTO (MOWHTO) with transection of the sMCL between October 2013 and September 2018 were retrospectively investigated. Clinical evaluations, including the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner and Lysholm scores, were performed preoperatively and at 2 years postoperatively. The radiographic parameters hip-knee-ankle (HKA) angle, joint line convergence angle on standing radiographs (standing JLCA), and weightbearing line (WBL) ratio were assessed preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. To evaluate valgus laxity, we assessed the valgus JLCA and medial joint opening (MJO) at the aforementioned time points using valgus stress radiographs. Results: All clinical results at the 2-year follow-up were significantly improved compared with those obtained at the preoperative assessment ( P < .001). The postoperative HKA angle significantly differed from the preoperative one, and no significant valgus progression was observed during follow-up (preoperative, 8.5°± 2.7°; 3 months, –3.5°± 2.0°; 6 months, –3.2°± 2.3°; 1 year, –3.1°± 2.3°; 2 years, –2.9°± 2.5°; P < .001) The mean WBL ratio was 62.5% ± 9.0% at 2 years postoperatively. The postoperative valgus JLCA at all follow-up points did not significantly change compared with the preoperative valgus JLCA (preoperative, –0.1°± 2.1°; 3 months, –0.2°± 2.4°; 6 months, –0.1°± 2.5°; 1 year, 0.1°± 2.5°; 2 years, 0.2°± 2.2°) The postoperative MJO at all follow-up points did not significantly change compared with the preoperative MJO (preoperative, 7.1 ± 1.7 mm; 3 months, 7.0 ± 1.7 mm; 6 months, 6.9 ± 1.9 mm; 1 year, 6.7 ± 1.8 mm; 2 years, 6.8 ± 1.8 mm). Conclusion: Transection of the sMCL during MOWHTO does not increase valgus laxity and could yield desirable clinical and radiographic results.

Revision Single-Stage Anterior Cruciate Ligament Reconstruction Using an Anterolateral Tibial Tunnel

2019 ◽  
Vol 33 (04) ◽  
pp. 410-416
Author(s):  
Sohrab Keyhani ◽  
Behzad Hanafizadeh ◽  
René Verdonk ◽  
Mohammadreza Minator Sajjadi ◽  
Mehran Soleymanha
Keyword(s):  
Revision Surgery ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Clinical Results ◽  
Activity Level ◽  
Acl Revision ◽  
Anterior Cruciate ◽  
Level Scale ◽  
Tegner Activity Level ◽  
Acl Revision Surgery

AbstractRevision anterior cruciate ligament (ACL) reconstruction is a technically demanding enterprise. Management of widened or previously malpositioned tunnels is challenging and often requires innovative approaches. The purpose of this study was to evaluate the function and clinical results of revision single-stage ACL surgery using an anterolateral tibial tunnel (ALTT). A consecutive series of knees with arthroscopic ACL revision surgery were analyzed prospectively between April 2012 and September 2015. Among the 93 patients presented with revision ACL reconstruction, 25 patients met the study inclusion criteria for the ALTT technique and were followed up for a minimum of 2 years (range: 24–51 months). The clinical results were evaluated by means of the Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner activity level scale, and the knee stability was assessed by the Lachman test, pivot shift test, and anterior drawer test. Magnetic resonance imaging (MRI) of the index knee before the surgery and 2 years after revision surgery was assessed. The mean IKDC subjective score, mean Tegner activity level scale, and mean Lysholm score significantly improved in all study participants. This study showed that ACL revision surgery with ALTT can reliably restore stability and provide fair functional outcomes in patients with ACL retear. One could expect acceptable lateral tibial tunnel length compared with medial tibial tunnel in classic ACL revision, intact bony surround, and good graft fixation. This technique is clinically relevant in that making an anterolateral tunnel in one-stage ACL revision surgery had a good subjective result with low complication rate in midterm follow-up.

Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results

2017 ◽  
Vol 46 (3) ◽  
pp. 617-622 ◽  
Author(s):  
Kohei Nishitani ◽  
Yasuaki Nakagawa ◽  
Shinichiro Nakamura ◽  
Shogo Mukai ◽  
Shinichi Kuriyama ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cartilage Repair ◽  
Japanese Orthopaedic Association ◽  
Autologous Transplantation ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Level Of Evidence ◽  
Second Look ◽  
Osteochondral Autologous Transplantation

Background: Plug protuberance occasionally occurs in osteochondral autologous transplantation (OAT). The incongruity of plugs results in poor clinical outcomes, especially in cases of protuberance. However, a surgical procedure to deal with this problem has not been reported. Purpose/Hypothesis: The purpose was to evaluate the efficacy and safety of cartilage resection of elevated plugs, with the hypothesis that patients whose elevated plugs were resected and leveled would achieve clinical outcomes equivalent to those of patients with flush plugs. Study Design: Cohort study; Level of evidence, 3. Methods: Cases (group P) included 22 patients who underwent OAT of the knee and whose plugs showed protuberance greater than 1 mm that was resected with a scalpel to obtain smooth congruity, while controls (group C) included 22 background-matched patients who did not require plug resection. The International Knee Documentation Committee (IKDC) subjective score, IKDC objective grade, and Japanese Orthopaedic Association score for knee osteoarthritis (JOA knee score) were used preoperatively and at the final follow-up (mean ± SD, 49.3 ± 18.1 months). International Cartilage Repair Society (ICRS) Cartilage Repair Assessment was used to evaluate lesion healing during the second-look arthroscopy. Results: IKDC subjective scores of group C (82.5 ± 11.8) and group P (82.1± 15.1) showed no difference at the final follow-up. On postoperative IKDC objective grading, 86% of group C and 82% of group P patients were graded as “nearly normal” or better ( P = .639). The mean JOA knee scores of group C (90.9 ± 8.9) and group P (90.1 ± 9.5) did not differ significantly ( P = .647). Nine second-look arthroscopies were performed in group C versus 8 in group P, and all patients had plugs that were graded as “nearly normal” or better by the ICRS Cartilage Repair Assessment. Larger plugs tended to be used in those patients who required resection. Conclusion: Resection of the elevated plug surface did not negatively affect patient outcomes in the midterm follow-up period.

scholarly journals Clinical Results after Arthroscopic Meniscus Repair for Recurrent Subluxation of the Lateral Meniscus

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0009
Author(s):  
Sang Hak Lee ◽  
Jin Hwan Ahn ◽  
Kyung Ho Yoon ◽  
Chan Il Bae
Keyword(s):  
Full Range ◽  
Lateral Meniscus ◽  
Clinical Results ◽  
Suture Technique ◽  
Meniscus Repair ◽  
Activity Level ◽  
Discoid Lateral Meniscus ◽  
Limited Function ◽  
Tegner Activity Level

Purpose: This study was undertaken to diagnose and to document clinical results and the technical aspects of arthroscopic meniscus repair for treating the recurrent subluxation with peripheral tears around popoliteal hiatus of the LM. Methods: Twenty two patients (23 knees) with symptomatic recurrent subluxation of the LM treated by arthroscopic meniscus repair were included. The inclusion criteria were (1) patients with knee pain, locking or snapping symptoms despite 3 months of conservative treatment, (2) non-discoid lateral meniscus, (3) stable knee, and (4) tears involving the red-white or red–red zone. All tears were repaired with either the modified all-inside suture technique only or a combination of the modified all-inside and modified outside-in techniques. Clinical results were evaluated preoperatively and at final follow-up using Tegner activity level, Lysolm knee, and Hospital for Special Surgery (HSS) scores. Results: All patients returned to their prior life activities with little or no limitations, and no reoperation was required after an average follow-up of 52.3 months(range, 24–160). At the final follow-up, all knees achieved a full range of motion. Catching sensation was experienced in three knees, and limited function during squatting and jumping was complained in two knees. However no patient had recurrence of a locking episode. At the last follow-up, the mean Tegner activity level had improved significantly from 3.7 (range, 2–6) to 7.2 (range, 3–10, p<0.0001), mean Lysolm knee score improved from 75.1 92.0 (range, 76-100) preoperatively to 92.0 (range, 76-100) at final follow-up (p < 0.0001), and mean preoperative HSS score improved from 83.4 to 94.6 at final follow-up (p < 0.0001). Conclusion: Arthroscopic meniscus repair using the modified all-inside suture and outside-in techniques showed excellent clinical outcomes for treating symptomatic recurrent subluxation with peripheral tears around popoliteal hiatus of the LM without any complications or recurrence. [Figure: see text][Figure: see text]

Younger age and greater preoperative function predict compliance with 2-year follow-up visits after ACL reconstruction: an analysis of the PIVOT multicentre trial

2018 ◽  
Vol 3 (5) ◽  
pp. 251-257 ◽  
Author(s):  
Jayson Lian ◽  
João Victor Novaretti ◽  
Neel K Patel ◽  
Adam C Popchak ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Rating Scale ◽  
Cruciate Ligament ◽  
Univariate Analysis ◽  
International Knee Documentation Committee ◽  
Activity Level ◽  
Level Of Evidence ◽  
Younger Age ◽  
Patient Reported ◽  
The Usa

ObjectivesThe purpose of this investigation was to identify clinical and demographic variables that may predict compliance, defined as patient follow-up at 1-year and 2-year postoperative appointments, after anterior cruciate ligament reconstruction (ACLR).MethodsA total of 107 patients undergoing primary ACLR across four centres were prospectively followed for 2 years. Demographic and clinical data were recorded preoperatively and postoperatively, including patient-reported outcomes such as the Marx Activity Rating Scale, Cincinnati Occupational Rating Scale (CORS), International Knee Documentation Committee Subjective Knee Evaluation Form and Activities of Daily Living Scale (ADLS). Compliance was retrospectively defined using the presence or lack of outcome measures at 1-year and 2-year postoperative visits. Univariate analysis was done to compare demographic and clinical variables between compliant and non-compliant patients at 1-year and 2-year follow-up. Significant variables were entered into a logistic regression model. Significance was set at p<0.05.ResultsThe overall rate of compliance at 1-year and 2-year postoperative appointments was 83.2% (89/107) and 57.0% (61/107), respectively. Regression analysis showed that residence in Kobe, Japan compared with Pittsburgh, USA (OR 10.28; 95% CI 1.0003 to 105.28), and ‘very strenuous’ (OR 16.74; 95% CI 3.21 to 87.43) and ‘strenuous’ (OR 18.78; 95% CI 2.01 to 175.78) preinjury activity level were independent factors associated with compliance at 1-year follow-up. At 2 years follow-up, younger age (OR 0.95; 95% CI 0.91 to 0.997), and greater preoperative score on CORS (OR 1.03; 95% CI 1.01 to 1.06) and on ADLS (OR 1.04; 95% CI 1.01 to 1.07) were independently associated with compliance.ConclusionWhile patients with greater level of strenuous activity were more likely to follow-up after ACL surgery at 1 year, patients who were younger and had higher preoperative function measured by CORS and ADLS were more likely to follow-up at 2 years. Differences in follow-up rates among the USA, Italy, Sweden and Japan may highlight important cultural, socioeconomic and infrastructural differences across international healthcare systems. Orthopaedic surgeons may consider the results of this study during preoperative discussion with their patients and design of future ACL clinical research trials.Level of evidenceLevel III, prospective cohort.

scholarly journals Midterm Clinical and Radiological Outcome After Autologous Matrix-induced Chondrogenesis (AMIC) for Osteochondral Lesions of the Talus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0051
Author(s):  
Lizzy Weigelt ◽  
Christian Pfirrmann ◽  
Stephan Wirth
Keyword(s):  
Osteochondral Lesion ◽  
Activity Level ◽  
Osteochondral Lesions ◽  
Mri Findings ◽  
Aofas Score ◽  
Sports Activity ◽  
Persistent Symptoms ◽  
Bone Edema ◽  
Ankle Function

Category: Ankle Introduction/Purpose: Autologous matrix-induced chondrogenesis (AMIC) has recently become an interesting treatment option for osteochondral lesions of the talus since it combines safety and efficacy with overcoming several drawbacks of other surgical techniques. With AMIC, donor side morbidity of osteochondral autografts is eliminated, two-step procedures like matrix-induced autologous chondrocyte implantation are minimized to a more cost-effective single step and restrictions due to limited availability of osteochondral allografts are resolved. The purpose of this study was to evaluate the therapeutic efficacy of AMIC by analyzing AMIC-repaired osteochondral talar lesions in consecutively treated patients after a minimum follow-up of 2 years. Methods: All patients with an osteochondral lesion of the talus treated with the AMIC technique completing a minimum follow-up of 2 years were enrolled in the study for clinical and radiological follow-up. Patients with additional procedures such as lateral ligament reconstruction or corrective calcaneal osteotomy were excluded. 31 of the 47 eligible patients (28 males, 13 females; mean age at surgery 35.7 (range, 13-75) years); body mass index 27.1+-4.7 kg/m2) could be retrospectively evaluated after a mean follow-up of 4.6 (range, 2.3-7.9) years. The preoperative defect size was 0.9+-0.5 (range 0.4-2.3) cm2. Only two osteochondral lesions were localized laterally. Data analysis included general demographics, the visual analogue scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) score for ankle function, the Tegner Score for sports activity, and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system for radiological evaluation. Results: The VAS improved significantly from 6.5+-2.0 preoperatively to 1.5+-2.2 at follow-up (p<0.001). The mean AOFAS score was 93.0+-8.2 (range, 74-100) points. The sports activity level improved significantly from 3.5+-1.8 points preoperatively to 4.9+-1.8 points at follow-up (p<0.001), but 29% did not reach their pre-injury level of activity. The MOCART score averaged 61.5+-21.2 (range, 0-95) points. Complete filling of the defect was seen in 41%, hypertrophy of the cartilage layer in 53%. Normal or nearly normal signal intensity was detected in 67%. All patients showed subchondral bone edema or cysts. The MRI findings did not correlate with the clinical outcome. 91% were satisfied with the outcome and would undergo the same procedure again. Conclusion: AMIC is a reliable procedure to treat osteochondral lesions of the talus. Significant pain reduction and high ankle function were observed after a mean midterm follow-up of 4.5 years. MRI findings did not reflect the good clinical results and therefore should only be performed to rule out other pathologies that might cause persistent symptoms.

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