Early results of Complete Cartilage Regeneration (CCR) technique for Talar Osteo-Chondral defects (OCD)

J. May, N. Obi, A. Bing, N. Makwana

Aim: To provide on going evidence and monitoring for a new surgical technique. In the single stage treatment of patients with cartilage defects of the talus.

Method: Bone marrow aspirate (35mls) is harvested from the posterior or anterior superior iliac spine of the pelvis. This is spun down into a Mesenchymal Stem Cell (MSC) rich concentrate. The concentrate is mixed with a Fibrin gel and hyaluronic acid. The resulting adherent mixture is glued onto the prepared defect, to form a MSC rich patch.

Results: Total number of patients to receive CRR to date is 52. There have been no serious adverse incidents to date. Average MOX-FQ summary index pre op was 68 and improved to 47 at 6 months, 39 at 12 months and 39 at 18 months post procedure. Average EQ5d-5L VAS pre op was 67 and improved to 73 at 6 months, 77 at 12 months and 73 at 18 months post procedure. Average AOFAS pre op was 57, this improved to 74 at 6 months, 81 at 12 months and 75 at 18 months post procedure. Average EQ-5d-5L index was 0.51 pre op, this improved to 0.65 at 6 months, 0.66 at 12 months and 0.79 at 18 months post procedure.

Conclusion: The early data gathered on this technique shows it to be safe and these early results are promising especially considering the trend towards continuing improvement.