In new research, doctors from Rizzoli Orthopedic Institute, University of Bologna, Bologna, Italy examined bone marrow derived stem cells and their impact on osteochondral lesions of the talus in ankle osteoarthritis.1 Here is a summary of their research:
Ankle osteoarthritis is a challenging pathology, often requiring surgical treatments. In young patients, joint sparing, biologic procedures would be desirable.
Recently, a few reports have described the efficacy of bone marrow stem cells in osteoarthritis. Considering the good outcomes of one-step bone marrow derived cells transplantation (BMDCT) for osteochondral lesions of the talus, the doctors applied this procedure for in concomitant ankle osteoarthritis. (The surgical implantation of a “patch” scaffold from donor cartilage).
56 patients, with an average age of 35.6 years (range 16-50), who suffered from osteochondral lesions of the talus and ankle osteoarthritis, were treated using BMDCT. All patients were clinically checked using patient assessment scoring, in the pre-operative setting until the final follow-up of 36 months. Weight-bearing radiographs and MRI evaluation using patient assessment scoring were performed, preoperatively and postoperatively.
The whole clinical outcome had a remarkable improvement at 12 months, a further amelioration at 24 months and a lowering trend at 36 months. Early osteoarthritis had better outcomes. 16 patients required another treatment and they were considered failures. Clinical outcome significantly correlates with osteoarthritis degree, Body Mass Index, associate procedures. Radiographs were in line with clinical results. MRI evaluation showed signs of osteochondral repair.
BMDCT showed encouraging clinical and radiological outcomes at short-term follow-up. This procedure should be applied in young and selected patients, excluding severe ankle degeneration, where the results are critical. Longer follow-ups and larger case series are needed to confirm these results and if this treatment could be effective in postponing end-stage procedures.
The use of surgery and scaffold as well as direct injections of stem cells are discussed in this full free access article from the Journal of Prolotherapy See Direct Bone Marrow Injections for Avascular Necrosis of the Talus).
1. Buda R, Castagnini F, Cavallo M, Ramponi L, Vannini F, Giannini S. “One-step” bone marrow-derived cells transplantation and joint debridement for osteochondral lesions of the talus in ankle osteoarthritis: clinical and radiological outcomes at 36 months. Arch Orthop Trauma Surg. 2015 Oct 15. [Epub ahead of print]
The post Osteochondral lesions of the talus in ankle osteoarthritis | Prolotherapy.org appeared first on About Prolotherapy.
