In patients who have early focal or partial area wear and tear in the ankle joint with loss of articular cartilage on one side of the joint (usually the talus bone that becomes scuffed in sports-related injuries or ankle instability), it may be possible to consider joint preservation surgery with a cartilage patch utilising the latest regenerative techniques.
During ankle arthroscopy we may be able to treat the area with nanofracture and cover the area with a synthetic membrane (synthetic collagen from porcine/pig material). We can then implant this with a layer seeded with the patients own bone marrow cells to provide some cover of the area to improve the life of your ankle joint.
This is known as Autologous Matrix Implant Chondrogenesis (AMIC) and Bone Marrow Stem Cell Therapy (BMAC) with Collagen Scaffold for Cartilage Regeneration surgery.
The operation takes about two hours, recovery is about three months and the chances of helping to reduce the pain immediately from 7/10 to 3/10.
The advantage of this approach is that we at least make an attempt to keep your ankle functional and intact.
This surgery including the membrane, nanofracture and bone marrow cells have been in use for over 10 years with good published results of 5 years showing better than microfracture alone. This data is being collected and measured by Mr Chana as well.
- potential membrane shearing off
- the nanofracture not working
- infection of 1%
There have been no reported adverse effects of the membrane as it does not have any cells and we use the patients own cells for the cartilage regeneration.
However, there is a risk that if fairly diffuse arthritis exists, that is not completely appreciated on the scans, the patient may end up having full blown ankle arthritis within a couple of years afterward and at which point you may need further counselling and interventional surgery.