Objective

To determine potential predictive associations between patient-/lesion-specific factors, clinical outcome and anterior ankle impingement in patients that underwent isolated autologous matrix-induced chondrogenesis (AMIC) for an osteochondral lesion of the talus (OLT).

Design

Thirty-five patients with a mean age of 34.7 ± 15 years who underwent isolated cartilage repair with AMIC for OLTs were evaluated at a mean follow-up of 4.5 ± 1.9 years. Patients completed AOFAS (American Orthopaedic Foot and Ankle Society) scores at final follow-up, as well as Tegner scores at final follow-up and retrospectively for preinjury and presurgery time points. Pearson correlation and multivariate regression models were used to distinguish associations between patient-/lesion-specific factors, the need for subsequent surgery due to anterior ankle impingement and patient-reported outcomes.

Results

At final follow-up, AOFAS and Tegner scores averaged 92.6 ± 8.3 and 5.1 ± 1.8, respectively. Both body mass index (BMI) and duration of symptoms were independent predictors for postoperative AOFAS and Δ preinjury to postsurgery Tegner with positive smoking status showing a trend toward worse AOFAS scores, but this did not reach statistical significance (P = 0.054). Nine patients (25.7%) required subsequent surgery due to anterior ankle impingement. Smoking was the only factor that showed significant correlation with postoperative anterior ankle impingement with an odds ratio of 10.61 when adjusted for BMI and duration of symptoms (95% CI, 1.04-108.57; P = 0.047).

Conclusion

In particular, patients with normal BMI and chronic symptoms benefit from AMIC for the treatment of OLTs. Conversely, smoking cessation should be considered before AMIC due to the increased risk of subsequent surgery and possibly worse clinical outcome seen in active smokers.

中文翻译：

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距骨骨软骨损伤的孤立自体基质诱导软骨形成后，吸烟与前踝撞击有关。

客观的

确定对距骨骨软骨病变 (OLT) 进行孤立自体基质诱导软骨形成 (AMIC) 的患者的患者/病变特异性因素、临床结果和前踝撞击之间的潜在预测关联。

设计

平均年龄为 34.7 ± 15 岁的 35 名接受 AMIC 单独软骨修复的 OLT 患者在平均随访 4.5 ± 1.9 年时进行了评估。患者在最终随访时完成了 AOFAS（美国骨科足踝协会）评分，在最终随访时完成了 Tegner 评分，并回顾了伤前和术前时间点。Pearson 相关和多变量回归模型用于区分患者/病变特异性因素、因前踝撞击而需要后续手术和患者报告的结果之间的关联。

结果

在最终随访中，AOFAS 和 Tegner 评分平均分别为 92.6 ± 8.3 和 5.1 ± 1.8。体重指数（BMI）和症状持续时间都是术后 AOFAS 和术后 AOFAS 损伤前的独立预测因子，Tegner 阳性吸烟状态显示出 AOFAS 评分变差的趋势，但这没有达到统计学意义（P = 0.054）。9 名患者（25.7%）因前踝撞击而需要后续手术。吸烟是与术后前踝撞击显着相关的唯一因素，在调整 BMI 和症状持续时间后，比值比为 10.61（95% CI，1.04-108.57；P = 0.047）。

结论

特别是，具有正常 BMI 和慢性症状的患者受益于 AMIC 治疗 OLT。相反，在 AMIC 之前应考虑戒烟，因为会增加后续手术的风险，并且在活跃吸烟者中可能会出现更差的临床结果。