Autologous Matrix induced Chondrogenesis plus Peripheral Blood Concentrate (AMIC+PBC) in chondral defects of the first metatarsophalangeal joint - 7-year follow-up.
Martinus Richter, Stefan Zech, Issam Naef, Stefan Andreas Meissner
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Abstract
Background: The aim of the study was to assess the 7-year-follow-up (7FU) after Autologous Matrix Induced Chondrogenesis plus Peripheral Blood Concentrate (AMIC+PBC) in chondral defects at the first metatarsophalangeal joint (MTP1).
Material and methods: In a prospective consecutive non-controlled clinical follow-up study, all patients with chondral lesion at MTP1 that were treated with AMIC+PBC from April 1, 2009 from July 17, 2016 to May 21, 2017 were included. Size and location of the chondral lesions, the Visual-Analogue-Scale Foot and Ankle (VAS FA) and the European Foot and Ankle Society Score (EFAS Score) before treatment and at 5FU were analysed and compared with previous 2- and 5-year-follow-up (2FU/5FU). Peripheral Blood Concentrate (PBC) was used to impregnate a collagen I/III matrix (Chondro-Gide, Wolhusen, Switzerland) that was fixed into the chondral lesion with fibrin glue.
Results: One hundred and ninety-eight patients with 228 chondral defects were included. In 21 % of patients no deformities in the forefoot were registered. The average degree of osteoarthritis was 2.2. The chondral defect size was 1.0 cm2 on average. The most common location was metatarsal dorsal (22 %), and in most patients one defect was registered (74 %). Corrective osteotomy of the first metatarsal was performed in 79 %. 176 (89 %)/164 (82 %)/159 (80 %) patients completed 2FU/5FU/7FU VAS FA/EFAS Scores were preoperatively 46.8/11.9 and improved 74.1/17.1//75.0/17.2//72.8/17.5 at 2FU/5FU/7FU on average. No parameter significantly differed between 2FU/5FU/7FU (ANOVA, p > 0.05).
Conclusions: In conclusion, AMIC+PBC as treatment for chondral defects at MTP1 as part of joint preserving surgery led to improved and high validated outcome scores at 7FU. The lack of significant differences between 2-year (2FU), 5-year (5FU), and 7-year (7FU) outcomes suggests plateaued benefits.
期刊介绍：
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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