Arthroscopic Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus

Abstract

Several options exist for the treatment of osteochondral lesions of the talus. Particulated juvenile cartilage allograft transplantation (PJCAT) has become a viable treatment modality for osteochondral lesions of the talus that are not amenable to microfracture or for which microfracture has failed. Arthroscopic placement of this type of graft obviates the need for osteotomy or plafondplasty and does not prevent additional procedures from being performed through an anterior approach. Special instrumentation and setup are not required to perform this procedure. Our arthroscopic technique for placement of particulated juvenile cartilage into osteochondral lesions of the talus is described. Case series and outcomes after arthroscopic ankle PJCAT are currently not reported within the literature; however, it is believed that the outcomes are at least similar to those of open ankle PJCAT.

Management of Osteochondral Lesions of the Talar Dome

“…This technique has the potential to replace hyaline cartilage architecture without donor site morbidity [ 85 ]. Particulated juvenile cartilage can be performed through either open or arthroscopic techniques without malleolar osteotomy because it does not require perpendicular access to the lesion as is often needed for autograft or allograft transfer [ 86 ]. However, if the lesions are unreachable, malleolar osteotomy can be performed if needed.…”

Juvenile Particulate Osteochondral Allograft for Treatment of Osteochondral Lesions of the Talus: Detection of Altered Repair Tissue Biochemical Composition Using 7 Tesla MRI and T2 Mapping

“…The investigators noted that based on their 6-month follow-up data, this process was visualized as incomplete (1). Adams et al (25) reported their experience with arthroscopically guided juvenile cartilage transplantation and concluded that juvenile particulate cartilage can be successfully used to treat talar lesions using arthroscopic techniques. A critical need exists to objectively assess cartilage repair tissue quality, which could serve as a biomarker for monitoring and predicting surgical and clinical outcomes in longitudinal studies (26).…”

Arthroscopic Technique for Treating Patella and Femoral Condyle Lesions With DeNovo Natural Tissue Allograft

“…Moreover, specifically for the knee successful results have been reported for the patella, trochlea and condyle with and without concurrent surgeries 5 . Treatment of talar lesions using arthroscopic techniques have also been described with comparable results to open methods 11, 12. Size of the lesion is important for preoperative planning with less reliable results in lesions >3 cm 2, 13…”