Seven-Year Follow-up of Matrix-Induced Autologous Implantation in Talus Articular Defects

Background. Osteochondral lesions of the talus (OLT) are difficult to treat because of the poor intrinsic healing capability of articular cartilage. Matrix-induced autologous chondrocyte implantation (MACI) has been shown to be a reliable method for treating cartilage lesions that fail to respond to traditional microfracture and debridement. The purpose of this study was to assess 7-year clinical follow-up data of this technique and demonstrate midterm success of this implant. Methods. A prospective investigation of MACI was performed on 10 patients with OLTs who had failed previous arthroscopic treatment. In all, 5 male and 5 female patients were included in the study. Of the 10 patients, 9 were available for 7-year follow-up. Functional and clinical evaluations were done at 7 years postoperatively using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot evaluation and the Short Form Health Survey (SF-36) and compared with preoperative values. Results. SF-36 data at 7 years showed significant improvements in Physical Functioning (P <.01), Lack of Bodily Pain (P <.1), and Social Functioning (P <.001) compared with preoperative data. The mean AOFAS hindfoot scores of the 9 patients at 7 years was 78.3 ± 18.1 (P =.05) compared with their preoperative mean of 61.8 ± 14.3. Conclusions. MACI provides a stable midterm chondral replacement strategy for osteochondral lesions that fail initial microfracture. Levels of Evidence: Level IV: Prospective case series.