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May 29, 2026Open Access

Comparison of Bone Marrow Stimulation and Particulated Autologous Cartilage Transplantation for Osteochondral Lesions of the Talus With a 2-Year Follow-up

BKBom Soo KimInha University KPKwang Hwan ParkYonsei University YYYeo Kwon YoonYonsei University

Key Points

This study aims to compare the efficacy of bone marrow stimulation and particulated autologous cartilage transplantation for osteochondral lesions of the talus.
Retrospective evaluation of symptomatic patients undergoing BMS or PACT from March 2015 to December 2022.
Clinical outcomes assessed using VAS, AOFAS score, and FAOS.
Cartilage quality evaluated through MOCART scores and ICRS grades.
At 1-year follow-up, PACT group had significantly higher FAOS quality of life scores (55.8 vs 75.5, P = .006).
2-year AOFAS scores were higher in the PACT group (84.9 vs 91.4, P = .021).
Postoperative MOCART scores were superior in the PACT group (55.3 vs 66.3, P = .048).

Abstract

Background: Osteochondral lesions of the talus (OLTs) are a common cause of disability and chronic ankle pain. Many surgical treatment methods are currently used to treat OLTs, including particulated autologous cartilage transplantation (PACT). Nonetheless, the relative outcomes of PACT for OLTs are unclear. Purpose: To compare the short-term efficacy of bone marrow stimulation (BMS) and PACT in patients with OLTs. Study Design: Cohort study; Level of evidence, 3. Methods: Consecutive symptomatic patients with OLT who underwent BMS or PACT from March 2015 to December 2022 were retrospectively evaluated for at least 2 years. Preoperative radiography and magnetic resonance imaging (MRI) were performed in all patients. Follow-up second-look arthroscopy and MRI were performed approximately 1 year postoperatively. Clinical outcomes were assessed using the pain visual analog scale (VAS), American Orthopaedic Foot AOFAS score 70.0 ± 7.1 vs 62.1 ± 11.0, P = .015; FAOS symptom 64.7 ± 17.1 vs 53.3 ± 17.9, P = .036). However, 1-year FAOS quality of life scores (55.8 ± 21.1 vs 75.5 ± 23.1, P = .006) and 2-year AOFAS scores were significantly higher in the PACT group (84.9 ± 11.4 vs 91.4 ± 8.6, P = .021). Postoperative MOCART scores were significantly higher in the PACT group (55.3 ± 24.0 vs 66.3 ± 20.6, P = .048). Moreover, second-look arthroscopy revealed that ICRS scores (9.7 ± 0.5 vs 10.0 ± 0.5, P = .037) and grades ( P = .001) were significantly better in the PACT group. Conclusion: Our study demonstrated that PACT achieved significantly superior morphologic cartilage regeneration compared with BMS in OLTs at 1-year follow-up. However, the differences in clinical outcomes between the 2 treatments were not significant. Notwithstanding, additional follow-up studies are needed to assess the effects of PACT on long-term outcomes.

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