Oliver Gottschalk1,2, Sebastian Felix Baumbach1,2, Sebastian Altenberger3, Daniel Körner4, Matthias Aurich5, Christian Plaass6, Sarah Ettinger6, Daniel Guenther7, Christoph Becher8, Hubert Hörterer1,2, Markus Walther1. 1. Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany. 2. Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany. 3. Center for Foot and Ankle Surgery, Schön Klinik Harthausen, Bad Aibling, Germany. 4. Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tübingen, Eberhard Karls University, Tübingen, Germany. 5. Center for Orthopedics and Trauma Surgery, Klinikum Mittleres Erzgebirge, Zschopau, Germany. 6. Department for Foot and Ankle Surgery, Diakovere Annastift, Orthopedic Clinic of the Hannover Medical School, Hannover, Germany. 7. Department of Orthopedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Witten, Germany. 8. Center for Knee, Hip, and Foot Surgery, ATOS Clinic, Heidelberg, Germany.
Abstract
OBJECTIVE: Osteochondral lesions of the talus are common injuries, with one of the leading treatment options being the M-BMS (matrix-augmented bone marrow stimulation) + I/III collagen scaffold. Osteotomy of the medial malleolus is not unusual but presents the risk of malunion or irritation by hardware. The aim of the study was to analyze data from the German Cartilage Society (Knorpelregister DGOU) to evaluate the influence of medial malleolar osteotomy on clinical results of M-BMS + I/III collagen scaffold. DESIGN: The ankle module of the Cartilage Register includes a total of 718 patients, while 45 patients met the inclusion criteria. Patients were treated with an M-BMS + I/III collagen scaffold of the medial talus, 30 without and 15 with an osteotomy of the medial malleolus. The follow-up evaluations included FAAM (Foot and Ankle Ability Measure), FAOS (Foot and Ankle Outcome Score), and VAS (visual analogue scale). RESULTS: Forty-five patients (22 male, 23 female) aged between 18 and 69 years (mean: 34 years) were included in this study. Between preoperative and 12 months postoperative, we noted a significant improvement in FAAM-ADL (Activity of Daily Living) (P = 0.004) as well as FAOS-Pain (P = 0.001), FAOS-Stiffness (P = 0.047), FAOS-ADL (P = 0.002), FAOS-Sport (P = 0.001), and FAOS Quality of Life (P = 0.009). There was no significant difference between patients who underwent an osteotomy or not. CONCLUSION: The results show a significant improvement in patients' outcome scores following a M-BMS + I/III collagen scaffold. No statistical difference was noted among those undergoing medial malleolar osteotomy.
OBJECTIVE: Osteochondral lesions of the talus are common injuries, with one of the leading treatment options being the M-BMS (matrix-augmented bone marrow stimulation) + I/III collagen scaffold. Osteotomy of the medial malleolus is not unusual but presents the risk of malunion or irritation by hardware. The aim of the study was to analyze data from the German Cartilage Society (Knorpelregister DGOU) to evaluate the influence of medial malleolar osteotomy on clinical results of M-BMS + I/III collagen scaffold. DESIGN: The ankle module of the Cartilage Register includes a total of 718 patients, while 45 patients met the inclusion criteria. Patients were treated with an M-BMS + I/III collagen scaffold of the medial talus, 30 without and 15 with an osteotomy of the medial malleolus. The follow-up evaluations included FAAM (Foot and Ankle Ability Measure), FAOS (Foot and Ankle Outcome Score), and VAS (visual analogue scale). RESULTS: Forty-five patients (22 male, 23 female) aged between 18 and 69 years (mean: 34 years) were included in this study. Between preoperative and 12 months postoperative, we noted a significant improvement in FAAM-ADL (Activity of Daily Living) (P = 0.004) as well as FAOS-Pain (P = 0.001), FAOS-Stiffness (P = 0.047), FAOS-ADL (P = 0.002), FAOS-Sport (P = 0.001), and FAOS Quality of Life (P = 0.009). There was no significant difference between patients who underwent an osteotomy or not. CONCLUSION: The results show a significant improvement in patients' outcome scores following a M-BMS + I/III collagen scaffold. No statistical difference was noted among those undergoing medial malleolar osteotomy.
Authors: Lizzy Weigelt; Rebecca Hartmann; Christian Pfirrmann; Norman Espinosa; Stephan H Wirth Journal: Am J Sports Med Date: 2019-05-14 Impact factor: 6.202
Authors: Oliver Gottschalk; Sebastian Altenberger; Sebastian Baumbach; Stefanie Kriegelstein; Florian Dreyer; Alexander Mehlhorn; Hubert Hörterer; Andreas Töpfer; Anke Röser; Markus Walther Journal: J Foot Ankle Surg Date: 2017-06-21 Impact factor: 1.286