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A study to evaluate the safety of platelet‐derived growth factor for treatment of osteochondral defects of the talus
Author(s) -
Younger Alastair,
Wing Kevin,
Penner Murray,
Cresswell Mark
Publication year - 2016
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-015-3549-0
Subject(s) - medicine , visual analogue scale , osteoarthritis , magnetic resonance imaging , surgery , ankle , reduction (mathematics) , radiology , nuclear medicine , pathology , alternative medicine , geometry , mathematics
Purpose An arthroscopic procedure for the treatment of osteochondral defects using platelet‐derived growth factor (PDGF) carried out in a matrix of tricalcium phosphate was developed. This prospective, case‐series‐based study was designed to evaluate the safety and clinical utility of this procedure. Methods Patients with an isolated osteochondral defect larger than 5 mm long, 3 mm wide, and 5 mm deep and smaller than 30 mm long, 25 mm wide, or 20 mm deep were considered for enrolment. Only patients with chronic lesions were enroled. Arthroscopic debridement was followed by the placement of recombinant human PDGF in a matrix of tricalcium phosphate. The Ankle Osteoarthritis Scale (AOS), visual analogue scale (VAS) for pain, and SF‐36 questionnaires were administered at 0, 2, 6, 12, and 24 weeks. Magnetic resonance imaging (MRI) and computed tomography (CT) scans were taken before and after surgery. Results Five patients were ultimately enroled in this proof‐of‐concept trial. All outcome measures demonstrated marked improvement from baseline to final follow‐up: The mean weight bearing VAS pain score improved by 49 %, and the mean AOS functional score improved by 28 %. Bone healing was seen on CT, and reduction in oedema signal was seen on MRI. Conclusion This new procedure may offer a promising alternative for the treatment of osteochondral defects. Further high‐quality studies are needed to confirm these results and to analyse the long‐term effects of the procedure. The clinical relevance of this study is that the procedure may provide a less invasive option with improved bone healing compared to standard techniques. Level of evidence IV.

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