The Bone, the Cartilage – Which Is It?
Autologous matrix-related chondrogenesis (AMIC) technique consists of bone marrow stimulation via microfracture, autograft filling of defect and application of collagen bilayer matrix. Reporting in Foot & Ankle International this month, Necip Selçuk Yontar, MD, et al. found good functional outcomes in 56 patients, at 32 months, using AMIC as a primary intervention in large talus OCD lesions greater than 150mm2.
Maybe it is not about the cartilage
In this same analysis the success rate plummeted with revision OCD lesions of the talus with a clinical success rate of 61.2%. Bone strategies, like OATS or even metal hemicaps, may provide mechanical support to the talus while re-establishing an articular surface. Nothing established but focal prosthetic replacement for large osteochondral defects of the talus is a good segment to watch.