Talus osteokondral lezyonlarında Osteokondral Otolog Transplantasyona karşı Otolog Matriks kaynaklı Kondrogenez; retrospektif karşılaştırma

Öz

Amaç: Bu retrospektif analizin amacı, talus osteokondral lezyonlarının (OLT) tedavisinde osteokondral otolog transplantasyon (OAT) ile otolog matriks kaynaklı kondrogenez (AMIC) tedavilerinin etkinliklerini karşılaştırmalı olarak değerlendirmektir Materyal ve Yöntem: Bu retrospektif kohort çalışmasında, ortalama yaşları 40,7 ± 12,6 olan (yaş aralığı 18-66) toplam 55 hasta (24 erkek, 31 kadın) incelenmiştir. Çalışma, dört hastada farklı zamanlarda gerçekleştirilen çift taraflı prosedürler nedeniyle toplam 59 ayak bileğini kapsamaktadır. Hastaların 22'si AMIC, 37'si ise OAT ile tedavi edilmiştir. Fonksiyonel sonuçlar, operasyon öncesi ve son takipte Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) skalası kullanılarak değerlendirilmiştir. OAT uygulanan hastalarda diz fonksiyonunun değerlendirilmesi için Lysholm Diz Skoru kullanılmıştır. Seri radyografik incelemelerle osteotomi hattının kaynama durumu, redüksiyon kaybı, greft çökmesi ve osteoartritin (OA) tedavi sonrası ilerlemesi değerlendirilmiş, OA'nın evrelendirmesinde Kellgren-Lawrence derecelendirme sistemi kullanılmıştır. Sonuçlar: Karşılaştırmalı analiz, AMIC ve OAT arasında AOFAS skorlarındaki iyileşme (p=0.467), OA'nın ilerlemesi (p=0.141) veya komplikasyon oranları (p=0.373) açısından istatistiksel olarak anlamlı bir fark olmadığını ortaya koymuştur. Sonuç: AMIC ve OAT, OLT'nin tedavisinde benzer başarı oranları ve sonuçlar ile etkili tedavi seçenekleri olarak karşımıza çıkmaktadır.

Anahtar Kelimeler

• Otolog osteokondral transplantasyon
• Mozaikplasti
• otolog matriks kaynaklı kondrogenez
• talus osteokondral lezyonu
• medial malleol osteotomisi

Osteochondral Autologous Transplantation versus Autologous Matrix-induced Chondrogenesis for talus osteochondral lesions; a retrospective comparison

Öz

Aim: This retrospective analysis aimed to evaluate the comparative efficacy of osteochondral autologous transplantation (OAT) versus autologous matrix-induced chondrogenesis (AMIC) in the management of osteochondral lesions of the talus (OLT). Materials and Methods: In this retrospective cohort study, 55 individuals (24 males, 31 females) with an average age of 40.7 ± 12.6 years (range 18-66 years) were included. The study assessed 59 ankles in total due to 4 patients undergoing bilateral procedures at separate intervals. Of these, 22 were treated using AMIC and 37 received OAT. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scale preoperatively and at the latest follow-up. The Lysholm Knee Score was utilized for evaluating knee function in patients subjected to OAT. Serial radiographic examinations of the ankle were conducted to assess osteotomy union, reduction loss, graft subsidence, and progression of osteoarthritis (OA) using the Kellgren-Lawrence grading system for post-treatment OA evaluation. Results: Comparative analysis revealed no statistically significant differences between AMIC and OAT in terms of improvement in AOFAS scores (p=0.467), progression of OA (p=0.141), or complication rates (p=0.373). Conclusion: Both AMIC and OAT present as effective therapeutic options for OLT, with comparable success rates and outcomes.

Anahtar Kelimeler

• Autologous osteochondral transplantation
• Mosaicplasty
• autologous matrix-induced chondrogenesis
• talus osteochondral lesion
• medial malleolar osteotomy

Kaynakça

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