Long-term results of osteochondral autograft transplantation of the talus with a novel groove malleolar osteotomy technique

Toker, Berkin; Erden, Tunay; Cetinkaya, Sarper M.; Dikmen, Göksel; Özden, Vahit Emre; Taşer, Ömer

doi:10.5606/ehc.2020.75231

Cited by 2 publications

(5 citation statements)

References 25 publications

(36 reference statements)

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“…There are hardly any studies reporting a minimum or even mean follow-up period of more than 10 years. In one of the longest reported follow-ups after AOT for OLT, 20 patients showed good results regarding the AOFAS score, VAS for pain, and Lysholm Score after a mean follow-up of 12 years (minimum follow-up, 10 years) [ 25 ]. In this study, the minimum follow-up was 18 years, and the PROs are comparable to the mid-term results of previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Favorable long-term clinical and radiologic outcomes with high survivorship after autologous osteochondral transplantation of the talus

Winkler

Geyer

Walzl

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate long-term clinical and radiologic outcomes of patients undergoing autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus (OLT) and to perform a correlation analysis between clinical and radiologic outcomes. Methods Thirty-five patients with a mean age of 32.2 ± 8.9 years undergoing AOT for OLT between 1997 and 2003 were available for follow-up after an average of 19.1 ± 1.4 years. Demographic, surgical, and injury-related data were collected. After a minimum 18-year follow-up, patient-reported outcome scores (PROs) were collected, including the American Orthopaedic Foot & Ankle Society (AOFAS) score, the Foot and Ankle Outcome Score (FAOS), Tegner Activity Scale, and Visual Analogue Scale (VAS) for pain of the ankle. The Lysholm Score and VAS for pain of the knee were collected to assess donor-site morbidity. Magnetic resonance imaging scans were obtained to conduct an assessment of the replaced cartilage using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scoring system. Any revision surgery (except symptomatic hardware removal and arthroscopic debridement) was defined as clinical failure. Results Favorable clinical and radiologic (MOCART score, 73.7 ± 16.7 points) outcomes without any donor-site morbidities were observed. Twenty-three (65.7%) patients were satisfied or very satisfied with the surgical treatment. Fourteen (40.0%) and 25 (71.4%) patients had no or minor limitations in their athletic and working performance, respectively. A significant correlation between the MOCART and the FAOS Sport and Recreational activities subscale was found (rs, 0.491; p = 0.033). Six (17.1%) patients met the criteria for clinical failure an average of 12.2 ± 6.6 years after AOT. Survival analysis demonstrated a mean estimated time of survival of 21.3 years (95% CI [19.55, 22.96]) and a 20-year survival rate of 77.9%. Conclusion Autologous osteochondral transplantation to treat OLT achieves high patient satisfaction and favorable PROs with a 20-year survival rate of almost 80%. Given the high clinical efficacy of AOT, this procedure can be recommended as a safe and promising technique for the long-term therapy of OLT. Level of evidence Level IV.

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Section: Discussionmentioning

confidence: 99%

“…Donor site morbidity has been reported to be the most common complication after AOT, occurring in 2–14% of patients [ 5 , 10 , 24 , 25 ]. Interestingly, none of the patients in this study complained of pain or discomfort at the donor site at final follow-up.…”

Section: Discussionmentioning

confidence: 99%

Favorable long-term clinical and radiologic outcomes with high survivorship after autologous osteochondral transplantation of the talus

Winkler

Geyer

Walzl

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…No donor site pain was reported from any patient in the three studies that harvested the autograft from the ipsilateral talus, nor in the one study that harvested the graft from the ipsilateral distal tibia [ 41 - 44 ]. Among the 19 studies that harvested the autograft from the ipsilateral knee, two did not report on donor site pain [ 25 , 45 ], while four reported zero cases of donor site pain, including one which harvested the autograft from the posterior femoral condyle [ 16 , 17 , 22 , 37 ]. Across the remaining 13 studies that harvested the autograft from the ipsilateral knee, a total of 48 out of 532 (9%) patients reported donor site pain at the final follow-up.…”

Section: Reviewmentioning

confidence: 99%

“…In addition, they did not perform a meta-analysis of their results. Finally, since the publication of that systematic review, a number of studies have been performed and published [14,[16][17][18][19][20][21][22][23][24][25]. Therefore, the aim of this systematic review and meta-analysis was to evaluate the current evidence for the use of OATS in the management of OLT.…”

Section: Introductionmentioning

confidence: 99%

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The Effectiveness of Osteochondral Autograft Transfer in the Management of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis

Feeney¹

2022

Cureus

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Osteochondral lesions of the talus (OLT) are common following ankle trauma. Operative treatment is often required, with osteochondral autografting frequently performed for large or cystic lesions, or following failed primary surgery. The aim of this systematic review was to evaluate the current evidence for osteochondral autograft transfer system (OATS) in the management of OLT. A systematic search of the PubMed, EMBASE, Scopus, and Cochrane Library databases was performed based on the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Study quality was assessed using the modified Coleman Methodology Score (CMS). Meta-analysis was carried out using RevMan, version 5.4 (The Cochrane Collaboration, 2020). A total of 23 studies were included. The mean modified CMS was 48.1±7.47. Fourteen studies reported preoperative and postoperative Visual Analog Scale (VAS) and American Orthopaedic Foot & Ankle Score (AOFAS). The aggregate mean preoperative and postoperative VAS score across 14 studies was 6.47±1.35 and 1.98±1.18, respectively. Meta-analysis of seven studies on 210 patients found that OATS resulted in a significant reduction in VAS score compared to baseline (Mean Difference {MD} -4.22, 95% Confidence Interval {CI} -4.54 to -3.90, P < 0.0001). The aggregate mean preoperative and postoperative AOFAS scores across 14 studies were 56.41±8.52 and 87.14±4.8, respectively. Based on eight studies on 224 patients, OATS resulted in a significant improvement in AOFAS score compared to baseline (MD 29.70, 95% CI 25.68 to 33.73, P = < 0.0001). Donor site pain occurred in 9% of cases. Current evidence from low-quality studies suggests that OATS is a safe and effective treatment option for OLT, though it is associated with a risk of donor site morbidity.

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Long-term results of osteochondral autograft transplantation of the talus with a novel groove malleolar osteotomy technique

Cited by 2 publications

References 25 publications

Favorable long-term clinical and radiologic outcomes with high survivorship after autologous osteochondral transplantation of the talus

Favorable long-term clinical and radiologic outcomes with high survivorship after autologous osteochondral transplantation of the talus

The Effectiveness of Osteochondral Autograft Transfer in the Management of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis

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