Jimmy Wen, Burhaan Syed, Ubaid Ansari, Vince Thomas, Mouhamad Shehabat, Muzammil Akhtar, Daniel Razick, Christopher D Kreulen
{"title":"Favorable Short-Term Outcomes of Matrix-Associated Autologous Chondrocyte Implantation for Osteochondral Lesions of the Talus: A Systematic Review.","authors":"Jimmy Wen, Burhaan Syed, Ubaid Ansari, Vince Thomas, Mouhamad Shehabat, Muzammil Akhtar, Daniel Razick, Christopher D Kreulen","doi":"10.1016/j.arthro.2025.07.045","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To synthesize the available research on matrix-associated autologous chondrocyte implantation (MACI) for osteochondral lesions of the talus (OLTs) by specifically focusing on clinical outcomes, patient-reported outcomes (PROs), return to activity/sport (RTA/RTS), and rates of complications/revisions.</p><p><strong>Methods: </strong>A search following the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed in three databases for studies including MACI repair for OLTs. Study variables included title, author, publication date, study year, number of patients/ankles, mean age, mean follow-up time, RTA/RTS, PROs, and rates of complications/revisions.</p><p><strong>Results: </strong>In total, 11 studies including 166 patients who underwent MACI with an age range of 17.7 to 45.8 years, a defect size range of 1.21 to 3.4 cm<sup>2</sup>, and a follow-up time of 21.1 to 144 months were included. Lesions treated were classified as Outerbridge III-IV, Hepple 3-4, International Cartilage Repair Society III-IV, or chronic-type lesions. The mean preoperative ranges for American Orthopedic Foot and Ankle Score (AOFAS) (9 studies) and Magnetic Resonance Observation of Cartilage Repair Tissue (1 study) were 36.9 to 70.1 and 62.4, respectively. The mean postoperative ranges for AOFAS (9 studies) and Magnetic Resonance Observation of Cartilage Repair Tissue (4 studies) were 78.3 to 95.3 and 62 to 83.8, respectively. Rates for RTA (1 study) and RTS (3 studies) were 81.8% and 50% to 82.4%, respectively. Complications and revisions ranged from 0% to 59% and 0% to 45%, respectively.</p><p><strong>Conclusions: </strong>MACI for OLTs is associated with improved AOFAS scores and RTA/RTS rates at short-term follow-up. Reported complication and revision rates ranged from 0% to 59% and 0% to 45%, respectively. No included studies reported minimal clinically important difference, patient acceptable symptom state, or substantial clinical benefit metrics, limiting the interpretation of patient-level clinical improvements.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of LOE III-IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.07.045","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To synthesize the available research on matrix-associated autologous chondrocyte implantation (MACI) for osteochondral lesions of the talus (OLTs) by specifically focusing on clinical outcomes, patient-reported outcomes (PROs), return to activity/sport (RTA/RTS), and rates of complications/revisions.
Methods: A search following the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed in three databases for studies including MACI repair for OLTs. Study variables included title, author, publication date, study year, number of patients/ankles, mean age, mean follow-up time, RTA/RTS, PROs, and rates of complications/revisions.
Results: In total, 11 studies including 166 patients who underwent MACI with an age range of 17.7 to 45.8 years, a defect size range of 1.21 to 3.4 cm2, and a follow-up time of 21.1 to 144 months were included. Lesions treated were classified as Outerbridge III-IV, Hepple 3-4, International Cartilage Repair Society III-IV, or chronic-type lesions. The mean preoperative ranges for American Orthopedic Foot and Ankle Score (AOFAS) (9 studies) and Magnetic Resonance Observation of Cartilage Repair Tissue (1 study) were 36.9 to 70.1 and 62.4, respectively. The mean postoperative ranges for AOFAS (9 studies) and Magnetic Resonance Observation of Cartilage Repair Tissue (4 studies) were 78.3 to 95.3 and 62 to 83.8, respectively. Rates for RTA (1 study) and RTS (3 studies) were 81.8% and 50% to 82.4%, respectively. Complications and revisions ranged from 0% to 59% and 0% to 45%, respectively.
Conclusions: MACI for OLTs is associated with improved AOFAS scores and RTA/RTS rates at short-term follow-up. Reported complication and revision rates ranged from 0% to 59% and 0% to 45%, respectively. No included studies reported minimal clinically important difference, patient acceptable symptom state, or substantial clinical benefit metrics, limiting the interpretation of patient-level clinical improvements.
Level of evidence: Level IV, systematic review of LOE III-IV studies.
期刊介绍：
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
