All-arthroscopic AMIC® (AT-AMIC): A Longlasting Procedure for the Treatment of Talar Osteochondral Defects. Long-term Follow-up Cross-sectional Study

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Various operative procedures have been used currently to treat osteochondral lesions of the talus (OLT). Among the new alternatives, Autologous Matrix-Induced Chondrogenesis (AMIC®) has proven to provide satisfactory results, with less soft tissue damage and a . The aim of this study is to assess the effectiveness, durability and possible complication of the arthroscopic matrix-induced chondrogenesis in patients with OLT at an average 3.5 years follow-up. Methods: This study is a multicentric retrospective cohort analysis that followed 64 patients diagnosed with osteochondral lesions of the talus, characterized by deep ankle pain whose diagnoses were confirmed through conventional radiology and Magnetic Resonance Imaging. All patients were treated following the same AT-AMIC® protocol by three Foot and Ankle Surgeons. Data collection took place between January 2016 and January 2022. The mean follow-up time was 44 months (IQR: 33–62 months). Inclusion criteria were adult patients diagnosed with osteochondral lesions of the talus, treated with the AT-AMIC® protocol. Data collection was carried out by reviewing the patients' medical records, focusing on demographic variables, lesion characteristics, and treatment outcomes. Results: At the final follow-up, there was a statistically significant improvement in clinical outcomes. The functional score demonstrated a increase of 38.1 points, rising from a preoperative score of 51.6 points to a postoperative score of 89.6 points ( p < 0.001). There was no significant association between associated procedures such as Broström repair or osteotomy, and the post-treatment AOFAS scores. The lesion area was negatively correlated with the functional score, indicating that larger lesion areas were associated with lower prior AOFAS scores (p = 0.045). Seven patients (11.0%) were categorized as experiencing treatment failure. The duration of symptoms prior to surgery showed no correlation with lesion size (p = 0.240). Lesion location, as determined by Raikin’s zones, demonstrated no significant influence on clinical outcomes Conclusion: AT-AMIC® is a reliable, reproducible and longlasting method for treating OLTs, reaching high clinical postoperative scores with a very low rate of complications in a long term follow-up . AT - amic arthroscopy technique A-C – Positioning the membrane . D-E – Fixation with fibrin glue. F – Final aspect.