Migliorini, F, Maffulli, N, Schenker, H, Eschweiler, J, Driessen, A, Knobe, M, Tingart, M and Baroncini, A (2021) Surgical Management of Focal Chondral Defects of the Talus: A Bayesian Network Meta-analysis. The American Journal of Sports Medicine. 3635465211029642 - ?.

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BACKGROUND: No consensus has been reached regarding the optimal surgical treatment for focal chondral defects of the talus.

PURPOSE: A Bayesian network meta-analysis was conducted to compare the clinical scores and complications of mosaicplasty, osteochondral auto- and allograft transplant, microfracture, matrix-assisted autologous chondrocyte transplant, and autologous matrix-induced chondrogenesis (AMIC) for chondral defects of the talus at midterm follow-up.

STUDY DESIGN: Bayesian network meta-analysis; Level of evidence, 4.

METHODS: This Bayesian network meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions. PubMed, Embase, Google Scholar, and Scopus databases were accessed in February 2021. All clinical trials comparing 2 or more surgical interventions for the management of chondral defects of the talus were accessed. The outcomes of interest were visual analog scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, rate of failure, and rate of revision surgery. The network meta-analysis were performed through the routine for Bayesian hierarchical random-effects model analysis. The log odds ratio (LOR) effect measure was used for dichotomous variables, and the standardized mean difference (SMD) was used for continuous variables.

RESULTS: Data from 13 articles (521 procedures) were retrieved. The median length of the follow-up was 47.8 months (range, 31.7-66.8 months). Analysis of variance revealed no difference between the treatment groups at baseline in terms of age, sex, body mass index, AOFAS score, VAS score, and mean number of defects. AMIC demonstrated the greatest AOFAS score (SMD, 11.27) and lowest VAS score (SMD, -2.26) as well as the lowest rates of failure (LOR, 0.94) and revision (LOR, 0.94). The test for overall inconsistency was not significant.

CONCLUSION: At approximately 4 years of follow-up, the AMIC procedure for management of focal chondral defects of the talus produced the best outcome.

Item Type: Article
Additional Information: For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journals-permissions
Uncontrolled Keywords: talus; chondral defect; AMIC; OAT
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 29 Sep 2021 15:16
Last Modified: 06 Dec 2021 10:14
URI: https://eprints.keele.ac.uk/id/eprint/10085

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