Arthroscopic matrix-associated chondrocyte implantation for osteochondral ankle lesions is safe and offers good overall clinical and magnetic resonance imaging results, according to these results.

Matthias Aurich, MD, of University Hospital in Jena, Germany, and colleagues performed a clinical and MRI review of 18 patients who had a total of 19 osteochondral ankle lesions and were treated with arthroscopic matrix-associated chondrocyte implantation (MACI) between February 2006 and May 2008. To assess the patients, the investigators used the pain and disability module of the Foot Function Index (FFI), the AOFAS clinical rating system, the Core Scale of the Foot and Ankle Module of the American Academy of Orthopaedic Surgeons (AAOS) Lower Limb Outcomes Assessment instruments, and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. They compared the clinical results for up to 3 years after MACI with preoperative data for 14 cases with MRI data for 19 cases.

All clinical scores improved significantly. The FFI pain scores improved from 5.5 + 2.0 (pre-MACI) to 2.8 + 2.2 (post-MACI). The FFI disability scores improved from 5.0 + 2.3 to 2.6 + 2.2. Other improvements were seen as follows:

• AOFAS: 58.6 + 16.1 to 80.4 + 14.1;
• AAOS standardized mean: 59.9 + 16.0 to 83.5 + 13.2; and
• AAOS normative score: 23.0 + 13.0 to MACI: 42.2 + 10.7.

The AOFAS Hindfoot score indicated that 64% were rated excellent and good; 36% were rated fair and poor. The results correlated with patient age and symptom duration, but not with lesion size. Sixteen patients reported regular sports participation before symptom onset. Thirteen returned to sports after MACI; nine returned to the same level. The mean MOCART score was 62.4 + 15.8 points. Although filling the defect somewhat correlated with AAOS score, there was no association between MOCART score and clinical outcome.

interesting results for a another potential weapon in our fight against ankle pain.

Bruce Werber DPM, FACFAS

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