Functional Outcome of Matrix-Associated Autologous Chondrocyte Implantation in the Ankle

Background: The technique of Matrix-associated autologous chondrocyte implantation (MACI) is well established with satisfactory outcomes up to 5 years in the knee. Fewer series describe the outcomes of this technique in the ankle. We present the functional outcomes of the technique for a single surgeon series in a general hospital setting. Materials and Methods: Twenty-seven patients, mean age 41, were reviewed at 3.7 (range, 1 to 5) years. Patients were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale, Tegener activity score and University of California lower extremity activity scale. MRI findings were also reviewed. Results: While most patients report a significant improvement in symptoms with full return to activities of daily living, 36% of those under 40 and 78% of those over 40 reported restricted recreational activity. Of the patients under 40 years of age, 86% were able to run compared with 23% of those over 40. Of patients over 40, 64% continued to have moderate or severe pain. Conclusion: Careful preoperative counseling is required for patients of all ages regarding likely outcomes. In patients over 40, the procedure is unlikely to give good pain relief and alternative options should be considered. Level of Evidence: IV, Case Series