{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:08:48Z","timestamp":1789016928342,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["REBORNE Project Grant 241876"],"award-info":[{"award-number":["REBORNE Project Grant 241876"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"award":["REBORNE Project Grant 241876"],"award-info":[{"award-number":["REBORNE Project Grant 241876"]}],"id":[{"id":"https:\/\/ror.org\/00k4n6c32","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]},{"id":[{"id":"https:\/\/ror.org\/00rbzpz17","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Joint-preserving options for bilateral non-traumatic ankle osteoarthritis (OA) are limited. This study evaluated whether intraosseous bone marrow concentrate (IO BMC) was associated with a lower observed occurrence of ankle arthrodesis or total ankle arthroplasty and greater procedure-free survival, and whether delivered colony-forming unit-fibroblast (CFU-F) count was associated with procedure-free survival. Materials and Methods: This retrospective, non-randomized, contralateral-controlled study included 88 patients with bilateral non-traumatic ankle OA treated between 2000 and 2014. The more symptomatic ankle received IO BMC, whereas the contralateral ankle was managed non-operatively. The primary endpoint was subsequent ankle arthrodesis or total ankle arthroplasty. Survival analyses were truncated at 15 years. Results: Arthrodesis or arthroplasty occurred in 16 of 88 IO BMC-treated ankles (18.2%) and 44 of 88 control ankles (50.0%). Thirty patients underwent a procedure only on the control side compared with two only on the IO BMC-treated side (p &lt; 0.001). In the adjusted Cox model, IO BMC treatment was associated with a lower hazard over 15 years (summary HR = 0.24, 95% CI 0.15 to 0.38, p &lt; 0.001), representing a summary association over the analysis interval rather than a constant effect. Restricted mean procedure-free survival was 9.89 versus 8.10 years through ten years (difference 1.78 years, 95% CI 1.28 to 2.32) and 14.23 versus 10.77 years through 15 years (difference 3.46 years, 95% CI 2.58 to 4.40). In an exploratory analysis with only 16 endpoint events, higher delivered CFU-F count remained associated with greater procedure-free survival (HR = 0.70 per 10,000-cell increase, 95% CI 0.55 to 0.90, p = 0.004). Conclusions: IO BMC treatment was associated with a lower observed occurrence of arthrodesis or arthroplasty and greater procedure-free survival in bilateral non-traumatic ankle OA. Higher delivered CFU-F counts were also associated with greater procedure-free survival in an exploratory analysis. These observational findings do not establish a causal treatment effect.<\/jats:p>","DOI":"10.3390\/medicina62091693","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:21:21Z","timestamp":1788452481000},"page":"1693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraosseous Bone Marrow Concentrate and Long-Term Procedure-Free Survival in Bilateral Non-Traumatic Ankle Osteoarthritis: A Contralateral-Controlled Study"],"prefix":"10.3390","volume":"62","author":[{"given":"Philippe","family":"Hernigou","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Paris-Est Cr\u00e9teil, 94010 Cr\u00e9teil, France"},{"name":"Orthopaedic Department, H\u00f4pitaux Universitaires Henri-Mondor, 94000 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Centeno","sequence":"additional","affiliation":[{"name":"Centeno-Schultz Clinic, Broomfield, CO 80021, USA"},{"name":"Regenexx, Broomfield, CO 80021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin R.","family":"Berger","sequence":"additional","affiliation":[{"name":"Regenexx, Broomfield, CO 80021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehren","family":"Dodson","sequence":"additional","affiliation":[{"name":"Regenexx, Broomfield, CO 80021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Regenexx, Broomfield, CO 80021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1530\/EOR-21-0117","article-title":"Ankle osteoarthritis: Comprehensive review and treatment algorithm proposal","volume":"7","author":"Valderrabano","year":"2022","journal-title":"EFORT Open Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"499","DOI":"10.2106\/JBJS.F.01299","article-title":"Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis","volume":"90","author":"Glazebrook","year":"2008","journal-title":"J. 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