Osteochondral Autografts for Osteochondritis Dissecans of the Talus

Abstract

Eighteen symptomatic advanced-stage osteochondritis dissecans (OCD) of the talus (Berndt and Harty stages III 7 and IV 11) in 17 patients were treated with multiple autogenous osteochondral cylindrical grafts. The mean time of follow-up was 36 months (range, 25-49). The average age at surgery was 22.7 years (range, 19-34). The mean size of defect of OCD was 13.6 mm x 7.2 mm. Two or three osteochondral grafts (6 or 7 mm in diameter and 15-20 mm in length) were harvested from the superomedial margin of the ipsilateral knee. A partial osteotomy of the medial malleolus or osteotomy of the distal lateral tibia was performed for all cases. Being evaluated by the Freiburg ankle score, 16 of 18 ankles (88.8%) had excellent and two (11.8%) had good results. "Second-look" arthroscopy of 16 ankles revealed consistency of the osteochondral grafts and congruity between grafts and native cartilage in 14 (87.5%), and a softening or fissuring of the osteochondral graft in two. Our results showed that this procedure provided an effective treatment for a symptomatic advanced-stage OCD of the talus.

No superior treatment for primary osteochondral defects of the talus

“…The range of the success percentages per study for the treatment strategy group of osteo(chondral) transplantation was 20 to 100% [CI 4–100%] (Fig. 3) [2, 3, 7, 22, 29, 36, 40, 47, 53, 54, 57, 62–64, 92, 105, 132, 136]. The range of the means of the success percentage per separate publication for the OATS group was 40–100% [CI 12–100%] (Fig.…”

Topographic Variations in Biomechanical and Biochemical Properties in the Ankle Joint: An In Vitro Bovine Study Evaluating Native and Engineered Cartilage

“…Unfortunately, treatment is particularly challenging, especially in young patients; unsatisfactory outcomes are commonly reported because of the inability to repair the articular cartilage damage and restore normal joint function. 2,16,17 Tissue engineering opens a new field in the management of ankle lesions by developing tissues that can replace the damaged cartilage. 18,19 A technique for the development of engineered scaffold-free neocartilage has been described.…”

Treatment of Osteochondral Lesions of the Talus with Transmalleolar Open Mosaicplasty

“…However, there are various contradictions regarding surgical indications and methods (12). Moreover, the choice of surgical technique depends largely on the experience of the surgeon as well as patient-related factors and the availability of surgical services (13)(14). Surgical techniques such as artroscopic debridement and microfracture lead to mechanical insufficiency of the fibrocartilaginous structure by exposing the bone (15).…”