Work

The influence of cell and platelet number on clinical outcomes provided by a one-step scaffold transplantation with bone marrow concentrate for the treatment of osteochondral lesions of the talus

Year: 2025

Type: article

Abstract: Purpose The aim of this study was to investigate if the numbers of cells and platelets in the bone marrow aspirate concentrate (BMAC) added to a hyaluronic acid membrane influence the clinical outcome up to long-term follow-up in the treatment of osteochondral lesions of the talus (OLTs). Methods A total of 102 patients with symptomatic OLTs underwent this one-step treatment. Eighty-five patients (53 men, 32 women, age 32.3 ± 10.6 years, lesion size 2.7 ± 1.6 cm 2 ) were prospectively evaluated at baseline and at 2–5–10 years using the AOFAS ankle-hindfoot score, the NRS for pain, and the Tegner score . Satisfaction and failures were documented as well. Laboratory analysis of BMAC was performed for the count of mononucleated cells (MNCs) and platelets. Results The AOFAS improved from baseline (59.1 ± 13.7) to the final follow-up (82.3 ± 14.9, p < 0.0005). NRS improved from 7.1 ± 1.1 at baseline to 3.9 ± 2.8 at the final follow-up (p < 0.0005). Tegner improved from a pre-op 2.0 median to 3.0 at the final follow-up (p < 0.0005), not reaching the pre-injury level. MNCs and platelets in BMAC were 148.2 ± 54.2 × 10 9 /L and 454.3 ± 277.5 × 10 9 /L, respectively. MNCs correlated with NRS at 2 years (p = 0.018; rho=-0.260). However, MNCs number, as well as platelet number, did not influence the improvement from baseline of the clinical scores at all follow-up evaluations. Conclusion This study demonstrated, in a large series of patients evaluated up to a long-term follow-up, that the number of MNCs and platelets present in BMAC does not influence the overall clinical outcomes in patients affected by OLTs treated with a one-step hyaluronic acid scaffold implantation augmented with BMAC. Level of evidence IV.

Source: Foot and Ankle Surgery

DOI: 10.1016/j.fas.2025.01.014