Bone marrow aspirate concentrate and scaffold for osteochond
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A research was performed to assess patients undergoing a one-step debridement procedure for long-term follow-up and BMAC seeded in situ on a scaffold for the treatment of osteochondral talus lesions (OLT) in osteoarthritis-affected (OA) ankles, recording the length of the clinical gain and its effectiveness in postponing end-stage procedures.

This series included 56 consecutive patients. Patients were evaluated preoperatively and up to a mean of 10 years of follow-up with the AOFAS score and the AOS scale, including pain and disability subscales. Furthermore, patients were asked to rate the satisfaction and failures were documented as well.

--The AOFAS score improved from 52.3?±?14.3 to 73.5±23.1 at 10 years; the AOS pain and disability subscales decreased from 70.9±14.1 to 37.2±32.7 and from 69.0±14.8 to 34.2±29.3.

--The overall rate of satisfaction was 61.8±41.2 and 68.6% of patients would undergo again the surgical procedure.

--A total of 17 failures was documented, for a failure rate of 33.3%. Older patients and those with more complex cases requiring previous or combined surgeries had lower outcomes, as well as those affected by grade 3 OA, who experienced a high failure rate of 71.4%.

Conclusively, this one-step technique for the treatment of OLT in OA ankles showed to be safe and to provide a satisfactory outcome, even if patients with end stage OA presented a high revision rate at 10 years. Moreover, this procedure was effective over time, with overall good results maintained up to a long-term follow-up.