Purpose
To clarify if the use of concentrated bone marrow aspirate (CBMA) would affect both
postoperative functional outcomes and magnetic resonance imaging (MRI) outcomes compared
with those of autologous osteochondral transplantation (AOT) alone; in addition, to
assess the efficacy of CBMA reducing the presence of postoperative cyst formation
following AOT in the treatment of osteochondral lesions of the talus.
Methods
Fifty-four (92%) of 59 eligible patients who underwent AOT between 2004 and 2008 were
retrospectively assessed at a minimum of 5-year follow-up. Twenty-eight patients were
treated with AOT and CBMA (AOT/CBMA group) and 26 patients were treated with AOT alone
(AOT-alone group). Clinical outcomes were evaluated using the Foot and Ankle Outcome
Scores (FAOS) and Short-Form 12 (SF-12) preoperatively and at final follow-up. Postoperative
MRI was evaluated with the modified Magnetic Resonance Observation of Cartilage Repair
Tissue (MOCART) scoring system. Cyst formation was also evaluated on postoperative
MRI.
Results
The mean FAOS and SF-12 significantly improved in both the AOT/CBMA and AOT-alone
groups, but there were no statistical differences between groups in FAOS (80.5 vs
75.5, P = .225) and SF-12 (71.1 vs 69.6, P = .756) at final follow-up. Additionally, there was no difference in the mean MOCART
score (80.4 vs 84.3, P = .484); however, AOT/CBMA did result in a statistically lower rate of cyst formation
(46.4% vs 76.9%, P = .022). No significant differences were found in the mean postoperative FAOS and
SF-12 between patients with and without cysts postoperatively.
Conclusions
CBMA reduced postoperative cyst occurrence rate in patients treated with AOT; however,
CBMA did not result in significant differences in medium term functional outcomes
and MOCART score in patients who underwent AOT.
Level of Evidence
Level III, retrospective comparative trial.
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Article info
Publication history
Published online: November 10, 2018
Accepted:
June 19,
2018
Received:
February 2,
2018
Footnotes
The authors report they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2018 by the Arthroscopy Association of North America
