Matrix-associated stem cell transplantation (MAST) versus autologous matrix induced chondrogenesis plus peripheral blood concentrate (AMIC+PBC) in chondral defects of the first metatarsophalangeal joint – A clinical cohort analysis

Abstract

Summary Background The aim of the study was to compare matrix-associated stem cell transplantation (MAST) with autologous matrix induced chondrogenesis plus peripheral blood concentrate (AMIC+PBC) in chondral defects at the first metatarsophalangeal joint (MTP1). Material and methods Patients with chondral defect at MTP1 that were treated with MAST from October 1, 2011 to July 15, 2016 (n = 623) or with AMIC+PBC from July 17, 2016 to March 19, 2018 (n = 230) were included. 480(89%)/176(89%) patients (MAST/AMIC+PBC) completed follow-up. Size and location of the chondral defects and the Visual-Analogue-Scale Foot and Ankle (VAS FA) and European Foot and Ankle Society Score (EFAS Score) before treatment and at follow-up were compared. Results In 20%/21% (MAST/AMIC+PBC) of patients no deformities in the forefoot were registered. The average were degree of osteoarthritis was 2.1/2.2 (MAST/AMIC+PBC). The chondral defect size was 0.9/1.0 cm2 on average (MAST/AMIC+PBC). The most common location was metatarsal dorsal (31/33%), and in most patients one defect was registered (74/74%)(MAST/AMIC+PBC). Corrective osteotomy of the first metatarsal was performed in 80%/79% (MAST/AMIC+PBC). VAS FA/EFAS Score were preoperatively 53.6/52.6//48.4/46.8 and improved to 72.4/74.1//16.8/17.1 at follow-up (MAST//AMIC+PBC) on average. No parameter significantly differed between MAST and AMIC+PBC cohorts. Conclusions MAST and AMIC+PBC as treatment for chondral defects at MTP1 as part of a (complex) joint preserving surgery led to improved and high validated outcome scores in 2-year-follow-up. MAST and AMIC+PBC showed similar results.