Osteochondral Transplantation of the Talus

Imhoff, Andreas B.; Paul, Jochen; Ottinger, Benjamin; Wörtler, Klaus; Lämmle, Lena; Spang, Jeffrey T.; Hinterwimmer, Stefan

doi:10.1177/0363546510397726

Cited by 124 publications

(50 citation statements)

References 37 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…3 ), for the mosaicplasty group 72–100% [CI 54–100%] and for one study that combined an OATS and an allograft procedure it was 83% [CI 55–95%] (Fig. 3 ) [ 2 , 3 , 29 , 40 , 47 , 54 , 57 , 63 , 64 , 132 , 136 ]. After extracting data on donor-site morbidity of 93 primary and secondarily treated talar OCDs by OATS, it became clear that 32% of the participants showed some form of donor-site knee joint morbidity [ 2 , 3 , 29 , 40 , 63 , 64 ].…”

Section: Resultsmentioning

confidence: 99%

“…It was possible to perform a simplified pooling method for those studies with a retrospective case series setting investigating an OATS procedure and an osteoperiosteal cylinder graft procedure, and this group of 78 treated talar OCDs yielded a pooled success rate of 77% [CI 66–85%] (Fig. 4 ) [ 3 , 40 , 53 , 54 , 63 , 64 , 132 ].…”

Section: Resultsmentioning

confidence: 99%

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No superior treatment for primary osteochondral defects of the talus

Dahmen

Lambers

Reilingh

et al. 2017

Knee Surg Sports Traumatol Arthrosc

138

131

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PurposeThe purpose of this systematic literature review is to detect the most effective treatment option for primary talar osteochondral defects in adults.MethodsA literature search was performed to identify studies published from January 1996 to February 2017 using PubMed (MEDLINE), EMBASE, CDSR, DARE, and CENTRAL. Two authors separately and independently screened the search results and conducted the quality assessment using the Newcastle–Ottawa Scale. Subsequently, success rates per separate study were calculated. Studies methodologically eligible for a simplified pooling method were combined.ResultsFifty-two studies with 1236 primary talar osteochondral defects were included of which forty-one studies were retrospective and eleven prospective. Two randomised controlled trials (RCTs) were identified. Heterogeneity concerning methodological nature was observed, and there was variety in reported success rates. A simplified pooling method performed for eleven retrospective case series including 317 ankles in the bone marrow stimulation group yielded a success rate of 82% [CI 78–86%]. For seven retrospective case series investigating an osteochondral autograft transfer system or an osteoperiosteal cylinder graft insertion with in total 78 included ankles the pooled success rate was calculated to be 77% [CI 66–85%].ConclusionsFor primary talar osteochondral defects, none of the treatment options showed any superiority over others.Level of evidenceIV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

No superior treatment for primary osteochondral defects of the talus

Dahmen

Lambers

Reilingh

et al. 2017

Knee Surg Sports Traumatol Arthrosc

138

131

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“…U novije se vrijeme za dijagnozu, prijeoperacijsko planiranje te poslijeoperacijsko praćenje OLT-a savjetuje obaviti MR kojim se uz određivanje stupnja odvojenosti koštanohrskavičnog fragmenta omogućuje i uvid u ostale karakteristike oštećenja (18)(19)(20)(21)(22). Iako trenutno nema jasnih smjernica o liječenju OLT-a za svaki pojedini stupanj, postoji konsensus o tome da oštećenja I. stupnja treba započeti liječiti neoperacijskim metodama u trajanju od tri do šest mjeseci.…”

Section: Rasprava I Zaključciunclassified

Operacijsko liječenje koštanohrskavičnih oštećenja talusa u djece

Bojanić

Jurina²,

Dimnjaković³

et al. 2015

Paediatr Croat

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UVODKoštanohrskavično oštećenje talusa (engl. Osteochondral Lesion of the Talus, u daljnjem tekstu OLT) lokalizirano je oštećenje koje zahvaća zglobnu površinu talusa, a očituje se aseptičkim odvajanjem komadića hrskavice s ili bez dijela pripadajuće subhondralne kosti. Valja istaknuti da je tradicionalni naziv za ovo stanje osteohondritis disekans talusa, no budući da upalna etiologija bolesti nikad nije dokazana, posljednjih se godina u medicinskoj literaturi umjesto tog naziva savjetuje uporabu termina koštanohrskavično ošte-ćenje talusa.Izbor najprikladnijeg načina liječenja OLT-a ponajviše ovisi o odvojenosti koštanohrskavičnog fragmenta od kosti, a na osnovi te odvojenosti zasnivaju se i radiološke klasifi kacije. Kod oštećenja I. i II. stupnja prema Berndt i Hartijevoj klasifi kaciji liječenje se savjetuje započeti neoperacijskim metodama, u prvom redu imobilizacijom te modifi kacijom tjelesnih aktivnosti (1). U slučaju neuspjeha neoperacijskog liječenja te kod oštećenja III. i IV. stupnja preporučuje se provesti operacijsko liječenje (2, 3). Metode operacijskog liječenja su: stimulacija koštane srži (engl. Bone Marrow Stimulation, u daljnjem tesktu BMS), fi ksacija koštanohrs-kavičnog fragmenta, prijenos autogenog koštanohrska-vičnog presatka (engl. Osteochondral Autograft Transfer System), implantacija autolognih hondrocita (engl. Autologous Chondrocyte Implantation) i transplantacija alogenog koštanohrskavičnog presatka (engl. Osteochondral Allograft Transplantation). U današnje vrijeme artroskopski BMS (bušenjem ili tehnikom mikrofraktura) primarna je metoda za operacijsko liječenje OLT-a kod odraslih bolesnika, jer se i nakon višegodišnjeg praćenja dobri ili izvrsni rezultati nala-

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“…Alternative techniques for treatment of focal cartilage defects in the talus are the osteochondral autograft transfer system (OATS), allograft or implantation of in vitro cultured autologous chondrocytes in ACI [ 1 , 14 , 24 ]. The OATS approach is associated with high donor site morbidity.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of focal cartilage defects in the talus with miniarthrotomy and collagen matrix

Walther

Altenberger

Kriegelstein

et al. 2014

Oper Orthop Traumatol

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Surgical principal and objectiveTreatment of focal cartilage defects (traumatic or osteochondrosis dissecans) of the talus using a collagen matrix. The goal is to stabilize the superclot formed after microfracturing to accommodate cartilage repair. The procedure can be carried out via miniarthrotomy, without medial malleolus osteotomy.IndicationsInternational Cartilage Repair Society (ICRS) grade III and IV focal cartilage defects of the talus > 1.5 cm2.ContraindicationsGeneralized osteoarthritis, inflammatory joint disease, gout, neuroarthropathy.Surgical techniqueMiniarthrotomy to open the ankle joint. Debridement of unstable cartilage and necrotic bone, curettage of cysts. Filling of the bone defects with autologous cancellous bone. Sealing of reconstructed bone with fibrin glue and attachment of a collagen matrix shaped to precisely fit the defect.Postoperative regimenImmobilization for 48 h. Partial weight bearing of 10 kg for 6 weeks, with continuous passive motion. Increasing weight bearing from 7 weeks onwards.ResultsFollow-up of at least 30 months in 14 patients showed improvement in the Score of the American Orthopedic Foot and Ankle Society (AOFAS) from 50 to 89 points, with equal mobility on both sides of the upper ankle joint.

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Osteochondral Transplantation of the Talus

Cited by 124 publications

References 37 publications

No superior treatment for primary osteochondral defects of the talus

No superior treatment for primary osteochondral defects of the talus

Operacijsko liječenje koštanohrskavičnih oštećenja talusa u djece

Reconstruction of focal cartilage defects in the talus with miniarthrotomy and collagen matrix

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