Scaffolds for cartilage repair of the ankle joint: The impact on surgical practice

BackgroundIdeal management of osteochondral lesions in the ankle joint is still theme of debate. Scaffold-based repair is emerging as a new approach for regenerative treatment.MethodsArticles published in PubMed from 2000 to January 2012 addressing cartilage scaffold-based treatment were identified, including levels I–IV evidence clinical trials with measures of functional, clinical or imaging outcome.ResultsThe analysis showed a progressively increasing number of articles from 2000. The number of selected papers was 19:15 focusing on two-step and 4 on one-step procedures; no randomized studies, 3 comparative studies, 11 case series and 5 case reports were identified.ConclusionsRegenerative surgical approach with scaffold-based procedures is emerging as a potential therapeutic option for the treatment of chondral lesions of the ankle. One step treatments simplify the procedure and the results reported are very close to the previous techniques. However, well-designed studies are lacking, and randomized long-term trials are necessary to confirm the potential of these techniques.Level of evidenceReview – IV.