Complex osteochondral lesions of the talus treated with a novel bi-phasic aragonite-based implant

Drobnič, Matej (author), Kolar, Matic (author), Verdonk, Peter (author), Vannini, Francesca (author), Robinson, Dror (author), Altschuler, Nir (author), Shabshin, Nogah (author), Kon, Elizaveta (author)

To present initial results of a novel, bi-phasic, porous, biodegrade, and cell-free aragonite-based scaffold for treating complex osteochondral lesions of the talus (OLT). Four subjects (2 males and 2 females; 34-61 years old) were operated on their ankles due to chronic and deep OLT-Hepple grades 4 or 5 (1.8-2.2 cm$^2$). Three subjects had OLT on the medial central trochlea, and 1 had a combined medial and lateral lesions. OLT were exposed through medial malleolus osteotomy, with an additional lateral arthrotomy in the combined lesions. Bi-phasic porous osteochondral scaffolds (single implant or 2 implants) were implanted in a press-fit manner using a designated surgical toolset. Treatment outcome was followed clinically (Foot and Ankle Outcome Score, EQ-5D 3L, Tegner activity scale) and by medical imaging (radiographs, magnetic resonance imaging) from 18 to 32 months. All Foot and Ankle Outcome Score values increased from preoperative to final follow-up values (Symptoms 62 to 71, Pain 53 to 84, ADL 60 to 89, Sport 19 to 65, and QoL 18 to 47). EQ-5D 3L increased from 0.59 to 0.76, and Tegner activity values increased from 1.5 to 3. Kellgren-Lawrence ankle radiographic scores remained stable (2 to 2). Postoperative MR evaluation demonstrated cartilage defect fill of 75% to 100% respect to the native cartilage in 3 subjects (4 OLTs), while 1 lesion was filled 25% to 50%. No graft related serious adverse events or graft failures were reported. The use of a bi-phasic osteochondral biodegradable aragonite-based scaffold in the treatment of complex OLT during the reported period presented positive and promising clinical and radiologic outcome, without serious adverse events or graft failures.

• Language: English
• Keywords: Agili-C™, ankle, aragonite, biodegradable implants, bi-phasic implants, cartilage, osteochondral lesions, scaffold, talus
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2021
• Number of pages: Str. 391-395
• Numbering: Vol. 60, iss. 2
• PID: 20.500.12556/RUL-138433
• UDC: 617.3
• ISSN on article: 1067-2516
• DOI: 10.1053/j.jfas.2020.06.028
• COBISS.SI-ID: 108232451
• Publication date in RUL: 20.07.2022

Record is a part of a journal

• Title: The journal of foot and ankle surgery
• Shortened title: J. foot ankle surg.
• Publisher: Elsevier, American College of Foot and Ankle Surgeons
• ISSN: 1067-2516
• COBISS.SI-ID: 1498431

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: ortopedija, nartnica, kirurgija, osteohondralne lezije talusa