Abstract
The treatment of osteochondral lesions in the ankle joint remains a challenging problem. While debridement and drilling or microfracture of the lesion reduce symptoms initially, long-term stability of the fibrous repair tissue is questionable. Osteochondral transplantation or mosaicplasty provide hyaline cartilage and repair the bony defect at the same time. However, an open arthrotomy with medial, lateral or anterior osteotomy is necessary to repair lesions of the talus. Lesions of the distal tibia cannot be reached. Matrix Associated Chondrocyte Implantation (MACI) has been shown to produce hyaline like cartilage repair tissue, and the implantation can be performed arthroscopically. Long term follow up studies (up to 10 years) in the knee demonstrate promising results.
The purpose of this study was to assess the efficacy of arthroscopic MACI for the treatment of osteochondral lesions in the ankle joint. We reviewed all patients (n=20) who had arthroscopic MACI treatment (n=22) between February 2006 and November 2008 clinically (Foot Function Index, AAOS Foot and Ankle Questionnaire, AOFAS-Hindfoot Score) and with MRI (3 Tesla Siemens MRI).
The clinical results and MRI findings up to three years after MACI were compared to pre-operative data. Possible correlations with the individual history and the nature, size or location of the lesion will be discussed. The surgical technique will be described. The results of the procedure are promising.
