Background

The aim of the study was to assess the 5-year-follow-up (5FU) after Autologous Matrix Induced Chondrogenesis plus Peripheral Blood Concentrate (AMIC+PBC) in chondral defects at the first metatarsophalangeal joint (MTP1).

Material and methods

In a prospective consecutive non-controlled clinical follow-up study, all patients with chondral lesion at MTP1 that were treated with AMIC+PBC from July 17, 2016 to May 31, 2017 were included. Size and location of the chondral lesions, the Visual-Analogue-Scale Foot and Ankle (VAS FA) and the EFAS Score before treatment and at 5FU were analysed and compared with previous 2-year-follow-up (2FU). Peripheral Blood Concentrate (PBC) was used to impregnate a collagen I/III matrix (Chondro-Gide, Wolhusen, Switzerland) that was fixed into the chondral lesion with fibrin glue.

Results

One hundred and ninety-eight patients with 238 chondral defects were included. In 21 % of patients no deformities in the forefoot were registered. The average degree of osteoarthritis was 2.2. The chondral defect size was 1.0 cm² on average. The most common location was metatarsal dorsal (33 %), and in most patients one defect was registered (74 %). Corrective osteotomy of the first metatarsal was performed in 79 %. 176 (89 %)/164 (83 %) patients completed 2FU/5FU. VAS FA/EFAS Score were preoperatively 46.8/11.9 and improved to 74.1/17.1 at 2FU and 75.0/17.3 at 5FU on average. No parameter significantly differed between 2FU and 5FU.

Conclusions

AMIC+PBC as treatment for chondral defects at MTP1 as part of joint preserving surgery led to improved and high validated outcome scores at 2FU and 5FU. The results between 2FU and 5FU did not differ.

中文翻译：

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自体基质诱导软骨形成加外周血浓缩物 (AMIC+PBC) 治疗第一跖趾关节软骨缺损 - 5 年随访

背景

该研究的目的是评估第一跖趾关节 (MTP1) 软骨缺损自体基质诱导软骨形成加外周血浓缩物 (AMIC+PBC) 后的 5 年随访 (5FU)。

材料与方法

在一项前瞻性连续非对照临床随访研究中，纳入了 2016 年 7 月 17 日至 2017 年 5 月 31 日期间接受 AMIC + PBC 治疗的所有 MTP1 软骨损伤患者。分析软骨损伤的大小和位置、足踝视觉模拟量表 (VAS FA) 以及治疗前和 5FU 时的 EFAS 评分，并与之前的 2 年随访 (2FU) 进行比较。外周血浓缩物 (PBC) 用于浸渍胶原蛋白 I/III 基质（Chondro-Gide，Wolhusen，Switzerland），该基质用纤维蛋白胶固定到软骨损伤处。

结果

包括 238 处软骨缺损的 198 名患者。在 21% 的患者中，前脚没有畸形。骨关节炎的平均程度为2.2。软骨缺陷尺寸平均为 1.0 cm ²。最常见的位置是跖骨背侧 (33 %)，大多数患者有一处缺损 (74 %)。79% 的患者进行了第一跖骨的矫正截骨术。176 (89 %)/164 (83 %) 名患者完成了 2FU/5FU。VAS FA/EFAS 评分术前为 46.8/11.9，在 2FU 时平均提高到 74.1/17.1，在 5FU 时平均提高到 75.0/17.3。2FU 和 5FU 之间的参数没有显着差异。

结论

AMIC+PBC 作为关节保留手术的一部分治疗 MTP1 的软骨缺损，导致 2FU 和 5FU 的结果评分得到改善和高验证。2FU 和 5FU 之间的结果没有差异。