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Year : 2019  |  Volume : 9  |  Issue : 1  |  Page : 1-5

Bone marrow stimulation plus bone marrow aspirate concentrate versus bone marrow stimulation alone in the treatment of osteochondral lesions of the talus: A prospective study

1 Department of Surgery, Duke University School of Medicine, Durham, NC, USA
2 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA

Correspondence Address:
Dr. John R Steele
Department of Orthopaedic Surgery, Duke Clinic Building Duke University Medical Center, Box 3000, 40 Medicine Circle, Room 5309, Durham, NC 27710
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DORJ.DORJ_5_19

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Background: Bone marrow stimulation (BMS) has proven to be the standard treatment for small osteochondral lesions of the talus (OLTs). It has been theorized that bone marrow aspirate concentration (BMAC) has the potential to enhance cartilage repair stimulated by BMS. The aim of this study was to prospectively compare the effect of BMS with BMAC versus BMS alone on patient-reported outcomes after the treatment of OLTs. Methods: This is a single-institution, randomized prospective study. Patients over the age of 18 with OLTs who were proceeding with BMS were included in the study. Patients with multiple OLTs and follow-up period of <1 year were excluded from the study. Patients were randomized to receive BMS alone or BMS with BMAC. Patient-reported outcome scores, including the visual analog scale pain, Short Musculoskeletal Function Assessment, Short Form-36, and Foot and Ankle Disability Index, were compared between the two cohorts. Results: Nine patients were evaluated in the study. Six patients were in the BMS with BMAC group, and three patients were in the BMS alone group. Average final follow-up was >2 years for both groups. Both groups showed improvements in patient-reported outcome scores from preoperatively to final follow-up. There were no significant differences in final outcome scores or changes in outcome scores from preoperatively to final follow-up between the two groups. Conclusion: Our study found that both BMS alone and BMS with BMAC treatments are effective in improving pain and functional outcomes in patients with OLTs. There were no significant differences between the two modalities of treatment. This is a pilot study and a larger randomized trial is needed to make definitive conclusions.

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