Osteochondral Lesions of the Talus and Autologous Matrix-Induced Chondrogenesis: Is Age a Negative Predictor Outcome?

Abstract

To assess and evaluate healing and functional outcomes after arthroscopic talus autologous matrix-induced chondrogenesis (AT-AMIC) in 2 age groups: patients older than 33 years versus patients 33 years or younger. A total of 31 patients, of whom 17 were 33 years or younger (G₁) and 14 older than 33 years (G₂), were evaluated. All patients were treated with AT-AMIC repair for osteochondral talar lesion. Magnetic resonance imaging (MRI) and computed tomography (CT)-scan evaluations, as well as clinical evaluations measured by the visual analog scale (VAS) score for pain, American Orthopaedic Foot and Ankle Society Ankle and Hindfoot score (AOFAS), and Short Form-12, were performed preoperatively (T₀) and at 6 (T₁), 12 (T₂), and 24 (T₃) months postoperatively. G₁ consisted of 17 patients (mean age: 25 years, standard deviation: ±5), whereas G₂ consisted of 14 patients (mean age: 47 years, standard deviation: ±9). In both groups, we found a significant difference for clinical and radiological parameters with the analysis of variance for repeated measures through 4 time points (P < .001). In G₁, AOFAS improved significantly between T₀ and T₁ (P = .025) and T₁ and T₂ (P = .011); CT showed a significant decrease between T₁ and T₂ (P = .003) and T₂ and T₃ (P < .0001), whereas MRI reduced significantly at each follow-up. In G₂, AOFAS improved between T₀ and T₁ (P = .011) and T₂ and T₃ (P = .018); CT decreased between T₁ and T₂ (P = .025), whereas MRI showed a reduction between T₁ and T₂ (P = .029) and T₂ and T₃ (P = .006). AOFAS in G₁ was significantly higher at T₀ (P = .017), T₂ (P = .036), and T₃ (P = .039) compared with G₂. A negative linear correlation between AOFAS and VAS at T₁ (R = -0.756), T₂ (R = -0.637), and T₃ (R = -0.728) was found in G₁, whereas in G₂, AOFAS was negatively correlated with VAS at T₁ (R = -0.702). The study revealed that osteochondral lesions of the talus were characterized by similar sizes and features, both in young and old patients. We conclude that AT-AMIC can be considered a safe and reliable procedure that allows effective healing, regardless of age, with a significant clinical improvement; in particular, clinical results are related to starting conditions of the ankle. Level IV, therapeutic case series.