Clinical outcomes of minced cartilage treatment (AutoCart™) for medial osteochondral lesions of the talus: a prospective one-year follow-up study

Background/Objectives:
This prospective study aims to assess the clinical outcomes of the AutoCart™ technique for the treatment of medial osteochondral lesions of the talus (OLT). 

Methods: 29 consecutive patients treated for medial OLT were included. Demographic characteristics and preoperative imaging (MRI and CT) were reviewed, and patient-reported outcome measures (PROMs)—including a Visual Analog Pain Scale (VAS), Foot Function Index (FFI), Foot and Ankle Ability Measure (FAAM), and the Veterans RAND 12-Item Health Survey (VR-12)—were assessed preoperatively and at 6 and 12 months post-treatment.

Results: In the cohort, 14 (48%) were female, 13 (45%) were male, and 2 (7%) did not disclose their gender. Median age was 35.5 years (interquartile range: 23.0–49.5). Mean defect size was 121.95 ± 84.46 mm2. Three patients were treated entirely arthroscopically, while 26 patients underwent medial malleolar osteotomy with cancellous bone grafting from the calcaneus for cartilage fragment placement. At one-year follow-up, there were significant improvements in pain and functional outcomes. The VAS score showed a mean reduction of 1.3 points (95% CI: −2.6 to −0.1; p = 0.036). Strong improvement was observed in the FFI, with a mean reduction of 13.3 points (95% CI: −21.0 to −5.6; p = 0.001). The FAAM Sports subscale showed a significant increase of 18.6 points (95% CI: 7.0 to 30.1; p = 0.002). 

Conclusions: Patients demonstrate clinical improvement after minced cartilage implantation with the AutoCart™ technique. These findings suggest that the minced cartilage procedure is a viable treatment option for medial OLTs, though further studies are needed to assess long-term efficacy.