BONE MARROW ASPIRATE CONCENTRATE FOR THE TREATMENT OF OSTEOCHONDRAL LESIONS OF THE TALUS: A SYSTEMATIC REVIEW OF OUTCOMES
DOI:
https://doi.org/10.53555/nnmhs.v9i2.1550Keywords:
Bone Marrow Concentrate, Mesenchymal Stem Cells, Osteochondral Lesions, TalusAbstract
Monro, who removed a loose body from the ankle produced by traumatic injury, most likely provided the first description of an ankle OCL. Monro was the first person to describe an ankle OCL. The most important thing that was discovered as a result of this investigation was that there was a dearth of information in the published literature concerning the use of BMAC for the treatment of OLTs with very different indications, associated procedures, and outcome evaluations. This was the finding that stood out the most. This was the most important finding that came out of the research. On the other hand, the clinical trials that were examined indicated a variety of positive outcomes for the treatment of modestly sized chondral lesions, and there were no major difficulties noted in any of the studies. Only one of the studies that were included in this analysis was prospective and made use of a control group. This is despite the fact that all three of the studies that were included in this review had a quality that varied from moderate to high, as judged by the mCMS. According to the findings of this investigation, there is an alarming lack of long-term data and high-level evidence to support the deployment of this treatment approach. These two types of evidence are needed to lend support for the utilization of this therapeutic strategy. In spite of this, the evidence that was readily available revealed that BMAC was helpful for the treatment of ankle cartilage anomalies, albeit with varying degrees of success. This was the case despite the fact that there was no cure for the condition.
References
Leumann A, Valderrabano V, Plaass C, Rasch H, Studler U, Hintermann B, et al. A Novel Imaging Method for Osteochondral Lesions of the Talus—Comparison of SPECT-CT With MRI. Am J Sports Med [Internet]. 2011 Feb 7;39(5):1095–
101. Available from: https://doi.org/10.1177/0363546510392709
Potter HG, Chong LR, Sneag DB. Magnetic Resonance Imaging of Cartilage Repair. Sports Med Arthrosc [Internet]. 2008;16(4). Available from: https://journals.lww.com/sportsmedarthro/Fulltext/2008/12000/Magnetic_Resona nce_Imaging_of_Cartilage_Repair.8.aspx
Saw K-Y, Hussin P, Loke S-C, Azam M, Chen H-C, Tay Y-G, et al. Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model. Arthrosc J Arthrosc Relat Surg. 2009;25(12):1391–400.
Kraeutler MJ, Chahla J, LaPrade RF, Pascual-Garrido C. Biologic options for articular cartilage wear (platelet-rich plasma, stem cells, bone marrow aspirate concentrate). Clin Sports Med. 2017;36(3):457–68.
Savage-Elliott I, Ross KA, Smyth NA, Murawski CD, Kennedy JG. Osteochondral lesions of the talus: a current concepts review and evidence-based treatment paradigm. Foot Ankle Spec. 2014 Oct;7(5):414–22.
Sampson S, Botto-van Bemden A, Aufiero D. Autologous bone marrow concentrate: review and application of a novel intra-articular orthobiologic for cartilage disease. Phys Sportsmed. 2013 Sep;41(3):7–18.
Kennedy JG, Murawski CD. The Treatment of Osteochondral Lesions of the Talus with Autologous Osteochondral Transplantation and Bone Marrow Aspirate Concentrate: Surgical Technique. Cartilage. 2011 Oct;2(4):327–36.
Giannini S, Buda R, Battaglia M, Cavallo M, Ruffilli A, Ramponi L, et al. Onestep repair in talar osteochondral lesions: 4-year clinical results and t2-mapping capability in outcome prediction. Am J Sports Med. 2013;41(3):511–8.
Vannini F. One-Step Repair in Talar Osteochondral Lesions. Am J Sports Med.
2013;41(3).
Fortier LA, Potter HG, Rickey EJ, Schnabel L V, Foo LF, Chong LR, et al. Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model. JBJS. 2010;92(10):1927–37.
Smyth NA, Murawski CD, Haleem AM, Hannon CP, Savage-Elliott I, Kennedy JG. Establishing proof of concept: platelet-rich plasma and bone marrow aspirate concentrate may improve cartilage repair following surgical treatment for osteochondral lesions of the talus. World J Orthop. 2012;3(7):101.
Betsch M, Schneppendahl J, Thuns S, Herten M, Sager M, Jungbluth P, et al. Bone marrow aspiration concentrate and platelet rich plasma for osteochondral repair in a porcine osteochondral defect model. PLoS One. 2013;8(8):e71602.
Hannon CP, Ross KA, Murawski CD, Deyer TW, Smyth NA, Hogan M V, et al. Arthroscopic bone marrow stimulation and concentrated bone marrow aspirate for osteochondral lesions of the talus: a case-control study of functional and magnetic resonance observation of cartilage repair tissue outcomes. Arthrosc J Arthrosc Relat Surg. 2016;32(2):339–47.
Vannini F, Filardo G, Altamura SA, Di Quattro E, Ramponi L, Buda R, et al. Bone marrow aspirate concentrate and scaffold for osteochondral lesions of the talus in ankle osteoarthritis: satisfactory clinical outcome at 10 years. Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2504–10.
Kim BS, Na Y, Jang D-S. Outcomes of bone marrow aspirate concentrate and matrix-induced chondrogenesis (BMIC) for treatment of osteochondral lesions of the talus. Foot ankle Surg Off J Eur Soc Foot Ankle Surg. 2022 Oct;28(7):944–
9.
Murphy EP, McGoldrick NP, Curtin M, Kearns SR. A prospective evaluation of bone marrow aspirate concentrate and microfracture in the treatment of osteochondral lesions of the talus. Foot Ankle Surg. 2019 Aug;25(4):441–8.
Dávila Castrodad IM, Simone ES, Kurowicki J, Melendez JX, Mease SJ, McInerney VK, et al. Improved Short-Term Outcomes of Osteochondral Lesions of the Knee Following Arthroscopic Treatment With Bone Marrow Aspirate Concentrate and Cartilage-Derived Matrix. Arthrosc Sport Med Rehabil. 2021 Apr;3(2):e477–84.
Chahla J, Mannava S, Cinque ME, Geeslin AG, Codina D, LaPrade RF. Bone Marrow Aspirate Concentrate Harvesting and Processing Technique. Arthrosc Tech. 2017 Apr;6(2):e441–5.
Ishijima M, Nakamura T, Shimizu K, Hayashi K, Kikuchi H, Soen S, et al. Intraarticular hyaluronic acid injection versus oral non-steroidal anti-inflammatory drug for the treatment of knee osteoarthritis: a multi-center, randomized, open-label, non-inferiority trial. Arthritis Res Ther. 2014;16(1):1–8.
Herrera-Perez M, Alrashidi Y, Galhoum AE, Kahn TL, Valderrabano V, Barg A.
Debridement and hinged motion distraction is superior to debridement alone in patients with ankle osteoarthritis: a prospective randomized controlled trial. Knee Surgery, Sport Traumatol Arthrosc. 2019;27:2802–12.
Giannini S, Buda R, Vannini F, Cavallo M, Grigolo B. One-step bone marrowderived cell transplantation in talar osteochondral lesions. Clin Orthop Relat Res.
2009 Dec;467(12):3307–20.
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