Riccardo D’Ambrosi
University of Milan, Italy
Title: The impact of weight on arthroscopic osteochondral talar reconstruction
Biography
Biography: Riccardo D’Ambrosi
Abstract
Purpose: to assess the functional and radiological outcomes after AT-AMIC® (arthroscopic talus autologous-matrix induced chondrogenesis) in 2 weight groups: patients with BMI <25 (Healthy Weight Group–HG) and with BMI ≥25 (Overweight Group-OG).
Methods: 37 patients were evaluated. All patients were treated with AT-AMIC® repair for osteochondral talar lesion. Magnetic Resonance Imaging (MRI), Computed-Tomography (CT), Visual Analgoue Scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score and Short-Form Healt Survey (SF-12) were performed preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively.
Results: HG was composed of 21 patients (BMI: 21.90±1.94), while OG consisted of 16 patients (BMI of 27.41±1.98). In both groups we found a significant difference for clinical and radiological parameters with ANOVA for repeated measures through four time points (p<0.001). In HG, AOFAS increased at every follow-up (p<0.05), VAS improved significantly between T0 and T1 (p<0.0001) and between T1 and T2 (p=0.0196). In OG, AOFAS improved only between T2 and T3 (p=0.0104), while VAS improved significantly between T0 and T1 (p<0.0001) and between T2 and T3 (p=0.0272). In HG the size of the lesion decreased significantly between T1 and T2 (p<0.05) and between T2 and T3 (p<0.05) both with CT and MRI, instead, in OG the size of the lesion in CT improved significantly only between T1 and T2 (p=0.007), while MRI showed a significant reduction of the lesion at each follow-up (p<0.05). In OG we found a significant difference comparing CT and MRI at each follow-up; in HG this difference was found only between T0 and T1 (p<0.0001) and T1 and T2 (p=0.0492). Finally, OG presented a significant bigger size lesion measured with MRI at T0 (p=0.033).
Conclusions: Osteocondral talar lesions in fatter patients are characterized by a bigger preoperative size, but no clinical differences were found between the two groups. AT-AMIC® can be considered a safe and reliable procedure, regardless of weight, with a significant improvement also in quality of life.