All-arthroscopic technique with autologous bone graft for talar osteochondral defects

INTRODUCTION: The aim of this study was to investigate the clinical and radiological efficacy of a new all-arthroscopic autologous matrix-induced chondrogenesis (AT-AMIC) technique for restoring osteochondral lesions of the talus in the human joint, by performing a systematic review. EVIDENCEACQUISITION: Asystematic review of the existing literature was performed to identify all studies dealing with AT-AMICtechnique. Two independent investigators performed the research using MEDLINE, Scopus, Embase and Cochrane Databases (1950 to January 2019). Main search items were "AMIC," "autologous matrix-induced chondrogenesis," "bone graft," "scaffold," "arthroscopy," "talus," "talar" "osteochondral lesion." Considering the heterogeneity of the data present in the literature we decided to divide the articles based on the primary outcomes into 6 categories: Clinical results; comparative studies; age; weight; edema; return to sport. EVIDENCESYNTHESIS: The initial search resulted in 120 articles, of which 8 articles were selected based on the eligibility criteria. Of the 8 studies, 6 (75.0%) were case series (level IV) and 2 (25.0%) comparative studies (level III). CONCLUSIONS: AT-AMICtechnique, performed entirely by arthroscopy, can be considered a safe and reliable technique, easily reproducible, with a negligible rate of complications. Future studies will focus on developing clinical trials comparing scaffolds able to promote the regeneration of the subchondral bone, which is fundamental for obtaining a coating that is more similar to hyaline cartilage.