Results of the AMIC® method in patients operated on for an osteochondral lesion of the talar dome (OLTD) at a mean follow-up of 34 months. A retrospective multicenter study

IF 2.2 3区医学 Q2 ORTHOPEDICS Orthopaedics & Traumatology-Surgery & Research Pub Date : 2025-11-01 DOI:10.1016/j.otsr.2024.104020

Matthieu Peras , Émilie Bilichtin , Camille Choufani , Alexandre Caubère , Olivier Barbier

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Abstract

Background

Symptomatic osteochondral lesions of the talar dome (OLTD) represent a real therapeutic challenge. In the absence of appropriate treatment, these lesions can evolve into tibiotalar osteoarthritis. Stage 3 lesion of the SFA classification and resistant to medical non-operative treatment may require surgical treatment. The results of the membrane-induced chondrogenesis (AMIC®) technique in the knee have been previously reported. At the ankle, few publications exist. Our objective was to evaluate clinical results of the AMIC® technique.

Hypothesis

AMIC® technique is clinically effective for the treatment of LODT with a minimum follow-up of 12 months after surgery.

Material and method

This was a multicenter (5 centers) retrospective study including patients operated on for an OLTD stage 3 of SFA between January 2019 and March 2021 using the AMIC® technique with a ChondroGide® membrane. A functional assessment by questionnaire (AOFAS, EFAS, FFI scores), clinical (VAS) and return to sport were carried out.

Results

21 patients (10 men and 11 women), aged 16–69 years (mean age 34 years) were included. The average follow-up was 34 months (min 12 months; max 72 months). The average loss of substance was 1.83 cm² (min 0.6 cm²; max 6 cm²). The results showed a significant improvement in the AOFAS functional score which went on average from 71 [CI = 64; 77] to 90 [CI = 82; 97], EFAS which went from 15 [CI = 10; 20] to 32 [CI = 10; 20] = 26; 38], FFI which went from 28% [CI = 19%; 38%] to 10% [CI = 2%; 18%] and the EVA which decreased by 4 [CI = 3.9; 4.7] to 1 [CI = 0.5; 2.4]. 60% of patients returned to sport at the same level and 80% of patients were satisfied with the surgery.

Discussion

AMIC® method improved the functional results of patients with SFA stage 3 OLTD at an average follow-up of 34 months post-operatively.

Level of evidence

IV; retrospective observational cohort study.

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平均随访 34 个月的距骨穹隆骨软骨损伤 (OLTD) 手术患者的 AMIC® 方法效果。一项多中心回顾性研究。

背景：有症状的距骨穹隆骨软骨损伤（OLTD）是一项真正的治疗挑战。如果缺乏适当的治疗，这些病变可演变为胫骨骨关节炎。SFA分类的第3期病变和对药物非手术治疗有抵抗力的病变可能需要手术治疗。膜诱导软骨生成（AMIC®）技术在膝关节方面的效果已有报道。但关于踝关节的报道却很少。我们的目标是评估 AMIC® 技术的临床效果：假设：AMIC®技术在治疗LODT方面具有临床疗效，术后随访至少12个月：这是一项多中心（5个中心）回顾性研究，研究对象包括2019年1月至2021年3月期间使用AMIC®技术和ChondroGide®膜进行SFA OLTD 3期手术的患者。通过问卷（AOFAS、EFAS、FFI 评分）、临床（VAS）和恢复运动进行了功能评估。结果：共纳入 21 名患者（10 男 11 女），年龄在 16-69 岁之间（平均年龄 34 岁）。平均随访时间为 34 个月（最短 12 个月；最长 72 个月）。平均物质损失为 1.83 平方厘米（最小 0.6 平方厘米，最大 6 平方厘米）。结果显示，AOFAS 功能评分有了明显改善，平均从 71 [CI = 64; 77] 上升到 90 [CI = 82; 97]；EFAS 从 15 [CI = 10; 20] 上升到 32 [CI = 10; 20] = 26; 38]；FFI 从 28% [CI = 19%; 38%] 下降到 10% [CI = 2%; 18%]；EVA 从 4 [CI = 3.9; 4.7] 下降到 1 [CI = 0.5; 2.4]。60%的患者恢复了同等水平的运动，80%的患者对手术表示满意：讨论：在术后平均34个月的随访中，AMIC®方法改善了SFA 3期OLTD患者的功能效果：证据级别：IV；回顾性观察队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedics & Traumatology-Surgery & Research 医学-外科

CiteScore

5.10

自引率

26.10%

发文量

329

审稿时长

12.5 weeks

期刊介绍： Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.