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Comparable function seen with addition of bone marrow aspirate to microfracture for talar osteochondral lesions
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NEW ORLEANS — A retrospective database review presented here of patients who underwent arthroscopic microfracture for osteochondral lesions of the talus indicates the addition of bone marrow aspirate concentrate yielded non-hyaline repair tissue and did not significantly improve functional scores.
“Our functional outcomes were similar between groups; however, MRI outcomes were improved with [bone marrow aspirate concentrate] BMC. Lesion size still has a significant impact on functional and radiological outcomes, and MRI T2 mapping showed a difference between the repair tissue and hyaline tissue,” Keir A. Ross, said during his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Ross and his colleagues compared the quantitative T2 mapping results and SF-12, Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART), Foot and Ankle Outcome Scores (FAOS) of 12 patients who underwent arthroscopic microfracture alone and 22 patients who had the procedure with the addition of BMC. Two surgeons performed the procedures, and the groups were relatively matched for gender, mean age, and preoperative lesion size and duration of symptoms. Overall, the patients had a mean follow-up of 5 years.
“The mean FAOS and SF-12 scores improved significantly in both groups,” Ross said.
Although the investigators found that BMC group had higher FAOS (17 points vs. 13 points) and SF-12 scores (19 points vs. 16 points) compared with the control group, the differences were not statistically significant.
“When we looked at our MOCART scores, we found that the average in the BMC group was 73 points out of 100 compared to 56 and this difference was significant,” Ross said. “Furthermore, when we looked at T2 mapping, we did find the contrast — that the quantification was different in the repair tissue than the control tissue. We also took values in the adjacent region of interest in normal cartilage and found the repair tissue was not the same.”
Age, gender and legion location did not significantly correlate with any of their outcome measures.
“However, we did find lesion size correlated negatively with MOCART scores and positively with the differences in T2 mapping. In other words, as the lesion size got larger, so did the difference between the repair tissue and normal tissue on T2 mapping,” Ross said. — by Gina Brockenbrough
Reference:
Ross KA. Paper #270. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
Disclosure: Ross has no relevant financial disclosures.