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• W2912030440 abstract "Matrix-associated stem cell transplantation (MAST) has shown good short-term results for treatment of chondral defects at first metatarsophalangeal joint (MTP1). The aim of the study was to assess mid-term results (≥4-year-follow-up). In a prospective consecutive non-controlled clinical follow-up study, 61 patients with 81 chondral defects at MTP1 that were treated with MAST from October 1, 2011 to October 31, 2014 were analysed. Degree of osteoarthritis, range of motion (ROM), size and location of the chondral defects, pedographic parameters, and the Visual Analogue Scale Foot and Ankle (VAS FA) before treatment and at follow-up were registered and analysed. Bone marrow aspirate was harvested from the ipsilateral pelvic bone marrow and centrifuged (10 min, 1500 RPM). The supernatant was used to impregnate a collagen I/III matrix (Chondro-Guide, Geistlich, Wollhusen, Switzerland). The matrix was fixed into the chondral defect with fibrin glue. Following mean (range) values were registered at time of surgery: age 44 (35–72) years, VAS FA 49.4 (12.3–82.3), ROM 20.4/0/8.4° (dorsiflexion/plantarflexion), degree of osteoarthritis 1.9 (1–3). The 81 chondral defects were located as follows, dorsal metatarsal head, n = 28 (35%), plantar metatarsal head, n = 12 (15%); dorsal & plantar, n = 21 (26%); medial sesamoid, n = 14 (17%); lateral sesamoid, n = 6 (7%) (two defects, n = 14, three defects, n = 3). The defect size was 0.9 (.5–3.0) cm2. Fifty-six patients (92%) completed follow-up at 62 (48–84) months. VAS FA increased to 82.5 (45.6–100; t-test, p < .01). ROM increased to 30.2/0/15.4 (p = .05). Degree of osteoarthritis decreased to 1.1 (0–3, p = .04). The surgical treatment of chondral defects at MTP1 including MAST led to improved clinical scores, ROM and degree of osteoarthritis after 4–7 years. No adverse effects of MAST were registered. Even though a control group is missing, we conclude that MAST is an effective method for the treatment of chondral defects at MTP1. Die Matrix-Assoziierte Stammzelltransplantation (MAST) hat gute kurzfristige Ergebnisse bei der Therapie von Knorpeldefekten am Großzehengrundgelenk (MTP1) gezeigt. Ziel dieser Studie war die Analyse von mittelfristigen Ergebnissen (≥4-Jahre-Nachuntersuchung). In einer prospektiven konsekutiven unkontrollierten Nachuntersuchungsstudie wurden 61 Patienten mit 81 Knorpeldefekten an MTP1, die mit MAST von 01.10.2011 bis 31.10.2014 behandelt wurden, analysiert. Arthrosegrad, Bewegungsumfang (ROM), Größe und Lokalisation des Knorpeldefekts, pedographische Parameter und Visual Analog Skala Fuß und Sprunggelenk (VASFA) wurden präoperativ und bei der Nachuntersuchung registriert und analysiert. Knochenmarkpunktat wurde am gleichseitigen Beckenkamm gewonnen und zentrifugiert (10 Minuten mit 1.500 Umdrehungen/Minute). Mit dem zellreichen Überstand wurde eine Kollagen-I/III-Matrix (Chondro-Gide) imprägniert. Diese Matrix wurde mit Fibrinkleber und die Knorpeldefekte eingeklebt. Zum OP-Zeitpunkt wurden folgende Mittelwerte (Spannweite) registriert: Alter 44 (35-72) Jahre, VAS FA 49,4 (12,3-82,3), ROM 20,4/0/8,4° (Dorsalextension/Plantarflektion), Arthrosegrad 1.9 (1-3). Die 81 Knorpeldefekte waren wie folgt lokalisiert: Metatarsalekopf dorsal, n = 28 (35%); Metatarsalekopf plantar, n = 12 (15%); dorsal & plantar, n = 21 (26%), mediales Sesambein, n = 14 (17%), laterales Sesambein, n = 6 (7%) (zwei Defekte, n = 14; drei Defekte, n = 3). Die Defektgröße betrug 0,9 (0,5-3,0) cm2. Sechsundfünfzig Patienten (92%) wurden nach 62 (48-84) Monaten nachuntersucht. VAS FA stieg auf 82.5 (45.6-100; t-test, p<.01). ROM stieg auf 30.2/0/15.4 (p=.05). Der Arthrosegrad verringerte sich auf 1.1 (0-3, p=.04). Die operative Behandlung von Knorpeldefekten and MTP1 mit MAST führte zu verbesserten Scores, ROM und Arthrosegrad nach 4-7 Jahren. Unerwünschte Ereignisse wurden nicht registriert. Auch unter Berücksichtigung der fehlenden Kontrollgruppe schlussfolgern wir, dass MAST eine effektive Methode für die Therapie von Knorpeldefekten an MTP1 darstellt." @default.
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• W2912030440 date "2019-03-01" @default.
• W2912030440 modified "2023-09-25" @default.
• W2912030440 title "Mid-term (4–7 years) results of matrix-associated stem cell transplantation (MAST) in chondral defects of the first metatarsophalangeal joint" @default.
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• W2912030440 doi "https://doi.org/10.1016/j.fuspru.2019.01.004" @default.
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