PDF(Pubmed)
Abstract：
OBJECTIVE: The objective of this study was to provide a comprehensive review of the existing literature regarding the treatment of osteochondral lesions of the talus (OLT) using autologous matrix-induced chondrogenesis (AMIC), while also discussing the mid-long term functional outcomes, complications, and surgical failure rate.
METHODS: We searched Embase, PubMed, and Web of Science for studies on OLT treated with AMIC with an average follow-up of at least 2 years. Publication information, patient data, functional scores, surgical failure rate, and complications were extracted.
RESULTS: A total of 15 studies were screened and included, with 12 case series selected for meta-analysis and 3 non-randomized controlled studies chosen for descriptive analysis. The improvements in the Visual Analog Scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot, and Tegner scores at the last follow-up were (SMD = - 2.825, 95% CI - 3.343 to - 2.306, P < 0.001), (SMD = 2.73, 95% CI 1.60 to 3.86, P < 0.001), (SMD = 0.85, 95% CI 0.5 to 1.2, P < 0.001) respectively compared to preoperative values. The surgery failure rate was 11% (95% CI 8-15%), with a total of 12 patients experiencing complications.
CONCLUSIONS: The use of AMIC demonstrates a positive impact on pain management, functional improvement, and mobility enhancement in patients with OLT. It is worth noting that the choice of stent for AMIC, patient age, and OLT size can influence the ultimate clinical outcomes. This study provides evidences supporting the safety and efficacy of AMIC as a viable treatment option in real-world medical practice.
METHODS: We searched Embase, PubMed, and Web of Science for studies on OLT treated with AMIC with an average follow-up of at least 2 years. Publication information, patient data, functional scores, surgical failure rate, and complications were extracted.
RESULTS: A total of 15 studies were screened and included, with 12 case series selected for meta-analysis and 3 non-randomized controlled studies chosen for descriptive analysis. The improvements in the Visual Analog Scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot, and Tegner scores at the last follow-up were (SMD = - 2.825, 95% CI - 3.343 to - 2.306, P < 0.001), (SMD = 2.73, 95% CI 1.60 to 3.86, P < 0.001), (SMD = 0.85, 95% CI 0.5 to 1.2, P < 0.001) respectively compared to preoperative values. The surgery failure rate was 11% (95% CI 8-15%), with a total of 12 patients experiencing complications.
CONCLUSIONS: The use of AMIC demonstrates a positive impact on pain management, functional improvement, and mobility enhancement in patients with OLT. It is worth noting that the choice of stent for AMIC, patient age, and OLT size can influence the ultimate clinical outcomes. This study provides evidences supporting the safety and efficacy of AMIC as a viable treatment option in real-world medical practice.
摘要：
目的：本研究的目的是提供关于使用自体基质诱导的软骨形成（AMIC）治疗距骨骨软骨损伤（OLT）的现有文献的全面综述，在讨论中长期功能结果的同时，并发症,和手术失败率。
方法：我们搜索了Embase，PubMed,和WebofScience对AMIC治疗的OLT的研究，平均随访至少2年。发布信息,患者数据,功能分数，手术失败率,并提取了并发症。
结果：共筛选并纳入15项研究，选择12个病例系列进行荟萃分析,选择3个非随机对照研究进行描述性分析.视觉模拟量比(VAS)的改进，美国骨科足踝协会（AOFAS）踝足，末次随访时的Tegner评分为（SMD=-2.825，95％CI-3.343至-2.306，P<0.001），（SMD=2.73，95%CI1.60~3.86，P<0.001），(SMD=0.85,95%CI0.5~1.2,P<0.001)与术前比较。手术失败率为11%（95%CI8-15%），共有12例患者出现并发症。
结论：使用AMIC对疼痛管理有积极影响，功能改进，OLT患者的活动能力增强。值得注意的是，支架的选择为AMIC，患者年龄,和OLT大小可以影响最终的临床结果。这项研究提供了支持AMIC作为现实医学实践中可行的治疗选择的安全性和有效性的证据。
方法：我们搜索了Embase，PubMed,和WebofScience对AMIC治疗的OLT的研究，平均随访至少2年。发布信息,患者数据,功能分数，手术失败率,并提取了并发症。
结果：共筛选并纳入15项研究，选择12个病例系列进行荟萃分析,选择3个非随机对照研究进行描述性分析.视觉模拟量比(VAS)的改进，美国骨科足踝协会（AOFAS）踝足，末次随访时的Tegner评分为（SMD=-2.825，95％CI-3.343至-2.306，P<0.001），（SMD=2.73，95%CI1.60~3.86，P<0.001），(SMD=0.85,95%CI0.5~1.2,P<0.001)与术前比较。手术失败率为11%（95%CI8-15%），共有12例患者出现并发症。
结论：使用AMIC对疼痛管理有积极影响，功能改进，OLT患者的活动能力增强。值得注意的是，支架的选择为AMIC，患者年龄,和OLT大小可以影响最终的临床结果。这项研究提供了支持AMIC作为现实医学实践中可行的治疗选择的安全性和有效性的证据。
