Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan;8(1):80-87.
doi: 10.1177/1947603516642574. Epub 2016 Apr 12.

Return to Sports After Bone Marrow-Derived Cell Transplantation for Osteochondral Lesions of the Talus

Francesca Vannini  1 , Marco Cavallo  1 , Laura Ramponi  1 , Francesco Castagnini  1 , Simone Massimi  1 , Sandro Giannini  2 , Roberto Emanuele Buda  1
Affiliations

Return to Sports After Bone Marrow-Derived Cell Transplantation for Osteochondral Lesions of the Talus

Francesca Vannini et al. Cartilage. 2017 Jan.

Abstract

Objective: Arthroscopic "one-step" technique based on bone marrow-derived cell transplantation (BMDCT) have achieved good results in repairing osteochondral lesions of the talus (OLT), overcoming important drawbacks of older techniques. It may be particularly adequate for the treatment of athletes in order to permit a safe and stable return to sports. The aim of this study was to report the results at 48 months of a series of athletes and the factors influencing the return to sports.

Design: Case series. A total of 140 athletes underwent a "one-step" BMDCT repair of OLT. All the patients had the cells harvested from the iliac crest, condensed and loaded on a scaffold, and then implanted. Patients were evaluated clinically by the American Orthopaedic Foot and Ankle Society (AOFAS) scores and Halasi score.

Results: AOFAS score improved from 58.7 ± 13.5 preoperatively to 90.6 ± 8.6 (P < 0.005) at 24 months, and to 90.9 ± 10.7 at 48 months. Halasi score was 6.88 ± 1.8 preinjury, 4.08 ± 1.7 preoperatively, and 5.56 ± 2.0 at final follow-up. At the final follow-up, all the patients (beside 1 failure and 3 lost) were able to return to activity and 72.8% were able to resume sports at preinjury level.

Conclusions: "One-step" BMDCT repair of OLT had good clinical results that was durable over time in athletes, permitting a return to sports at preinjury level in the majority of patients. The preoperative presence of impingement and articular degeneration were the main negative prognostic factors.

Keywords: ankle; articular cartilage; cartilage repair; mesenchymal stem cells; sports injury.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Graph showing the pattern of the mean American Orthopaedic Foot and Ankle Society (AOFAS) score evaluated at established follow-up up to 72 months.
Figure 2.
Figure 2.
Graph showing the pattern of Halasi score evaluated at pre-injury time, before surgery and at last follow-up.
Figure 3.
Figure 3.
Graph showing the rate of patients and the time returning to the same level of sport activities.
Figure 4.
Figure 4.
Graph showing the rate of patients and the time returning to the same level of sport activities shared into 2 groups: athletes with and without arthritis. Lower number of patients with arthritis in their ankle resumed sports after surgery at same level of activity.
See this image and copyright information in PMC

References

    1. Buda R, Vannini F, Castagnini F, Cavallo M, Ruffilli A, Ramponi L, et al. Regenerative treatment in osteochondral lesions of the talus: autologous chondrocyte implantation versus one-step bone marrow derived cells transplantation. Int Orthop. 2015;39(5):893-900. - PubMed
    1. Gerards RM, van Eekeren ICM, van Dijk CN. Rehabilitation and return to sports activity after debridement and bone marrow stimulation of osteochondral talar defects. In: Canata GL, van Dijk CN, editors. Cartilage lesions of the ankle. 1st ed. Berlin, Germany: Springer-Verlag; 2015. P. 87-98.
    1. Hannon CP, Smyth NA, Murawski CD, Savage-Elliott I, Deyer TW, Calder JD, et al. Osteochondral lesions of the talus: aspects of current management. Bone Joint J. 2014;96-B(2):164-71. - PubMed
    1. Saxena A, Eakin C. Articular talar injuries in athletes: results of microfracture and autogenous bone graft. Am J Sports Med. 2007;35(10):1680-7. - PubMed
    1. Kish G, Modis L, Hangody L. Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete: rationale, indications, technique, and results. Clin Sports Med. 1999;18:45-66. - PubMed

LinkOut - more resources