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Study highlights impact of age on outcomes of MACI in the ankle
Dixon S. Foot Ankle Int. 2011; Apr;32(4).
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Although matrix-associated autologous chondrocyte implantation in the ankle provided symptom relief in most patients in this study, more than half of older patients reported limited recreational activity and continued pain.
“Careful preoperative counseling is required for patients of all ages regarding likely outcomes,” Sean Dixon, FRCS, and colleagues wrote. “In patients over 40, the procedure is unlikely to give good pain relief and alternative options should be considered.”
The study involved 27 patients with a mean age of 41 years who had matrix-associated autologous chondrocyte implantation performed in the ankle by a single surgeon. The investigators postoperatively reviewed the MRI findings and functional outcomes of the patients using the AOFAS hindfoot scale, University of California lower extremity actively scale and Tegner activity score at 3.7 years.
The investigators noted that most patients had a “significant improvement” in symptoms and fully returned to activities of daily living. However, a comparison of patients younger than 40 years with those who were older than 40 years showed that more older patients had restricted recreational activity (78% vs. 36%) and fewer were able to run (23% vs. 86%). In addition, nearly 65% of older patients continued to have moderate or severe pain.