All-arthroscopic AMIC® (AT-AMIC) for the treatment of talar osteochondral defects

Category: Arthroscopy Introduction/Purpose: Various operative procedures have been used to treat osteochondral lesions of the talus. Among the new alternatives to treat these lesions, Autologous Matrix-Induced Chondrogenesis (AMIC®) has proven to provide satisfactory results through medium-term follow-up. The aim of this study is to report early post-operative clinical results of patients submitted to the AT-AMIC® technique and autologous bone graft, when necessary, for OLT’s at a six-month minimum follow-up. Methods: This is case series of 17 consecutive patients that were submitted to AT-AMIC®, between january of 2016 and april of 2017. 9 men and 8 women, between 15 and 67 years were diagnosed with OLTs with the typical history of deep ankle pain and corresponding magnetic resonance imaging injury. Surgery was proposed only after failure of conservative treatment of at least 3 months. Surgeries were performed by three different surgeons, with high arthroscopic experience. Patients answered the AOFAS score preoperatively and at the last follow-up, ranging from 6 to 18 months Results: Average size of OLTs were 1,12 cm2, with Raikin 4 location being the most common (70,5%). Calcaneal osteotomy was the most common associated procedure, with 17,6%. Average follow-up was 10,76 months. Average AOFAS before surgery was 46,35, increasing to 89,53 at the last follow-up. This difference was statistically significant with a p-value of <0,001. No complications were observed and no changes in the post-operative protocol were needed. Conclusion: AT-AMIC® is a reliable and reproducible method of treatment for OLTs, reaching high clinical postoperative scores, with a very low rate of complications. Further comparative study is needed to prove its efficacy.