Objective

To evaluate the effect of intra-articular injection of autologous micronized adipose tissue (MAT) with ankle arthroscopic debridement in patients with advanced-stage posttraumatic osteoarthritis (PTOA) of ankle.

Design

A retrospective cohort study investigating patients treated with arthroscopic debridement and autologous MAT injection for ankle PTOA was performed. Patients with Kellgren-Lawrence (KL) grade 3 to 4 were included. Visual analogue scale (VAS), Foot and Ankle Outcome Scores (FAOS), and patient satisfaction were evaluated.

Results

A total of 19 patients (19 ankles) were included (KL grade 3, 8 patients; grade 4, 11 patients). At a mean follow-up time of 14.3 months (range, 7-23 months), the mean FAOS subscales for pain and quality of life significantly increased from 48.8 and 20.1 preoperatively to 61.1 and 30.1 (P = 0.029 and 0.048, respectively). The mean VAS score significantly improved from 6.1 to 3.8 (P = 0.003) at final follow-up. A total of 10.5% (2/19) of patients were very satisfied, 31.6% (6/19) satisfied, 26.3% (5/19) neutral, 21.1% (4/19) unsatisfied, and 10.5% (2/19) very unsatisfied with their outcomes. The overall FAOS score demonstrated a significant difference in pre- to postoperative change with 14.8 for KL grade 3 and 5.9 for KL grade 4 (P = 0.048).

Conclusions

Autologous MAT injection is a safe and potentially beneficial procedure for advanced-stage ankle PTOA as an adjunct to arthroscopic debridement, although more than one-third of patients were unsatisfied with the procedure. This procedure may be more beneficial for KL grade 3 patients than grade 4 patients. However, future investigations are necessary to define the role of MAT for ankle PTOA.

中文翻译：

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关节镜清创和自体微粉化脂肪组织注射治疗晚期创伤后踝关节骨关节炎。

客观的

评估关节腔内注射自体微粉化脂肪组织 (MAT) 联合踝关节镜清创对晚期踝关节创伤后骨关节炎 (PTOA) 患者的疗效。

设计

进行了一项回顾性队列研究，调查接受关节镜清创和自体 MAT 注射治疗踝关节 PTOA 的患者。包括 Kellgren-Lawrence (KL) 3 至 4 级的患者。评估视觉模拟评分（VAS）、足踝结果评分（FAOS）和患者满意度。

结果

共纳入 19 名患者（19 名脚踝）（KL 3 级，8 名患者；4 级，11 名患者）。在平均 14.3 个月（范围，7-23 个月）的随访时间中，疼痛和生活质量的平均 FAOS 分量表从术前的 48.8 和 20.1 显着增加至 61.1 和 30.1（分别为P = 0.029 和 0.048）。最终随访时，平均 VAS 评分从 6.1 显着提高至 3.8（P = 0.003）。共有 10.5% (2/19) 的患者非常满意，31.6% (6/19) 满意，26.3% (5/19) 中立，21.1% (4/19) 不满意，10.5% (2/19) ) 对他们的结果非常不满意。总体 FAOS 评分显示，KL 3 级为 14.8，KL 4 级为 5.9（P = 0.048）。

结论

自体 MAT 注射是晚期踝关节 PTOA 的一种安全且潜在有益的手术，作为关节镜清创的辅助手段，尽管超过三分之一的患者对该手术不满意。该程序对 KL 3 级患者可能比 4 级患者更有益。然而，未来的研究对于定义 MAT 在踝关节 PTOA 中的作用是必要的。