Surgical treatment of a navicular osteochondral lesion using microionized cartilage matrix: A case report

Abstract

Osteochondral lesions of the tarsal navicular are uncommon but can lead to long-term complications if misdiagnosed or left untreated. Recent literature suggests successful outcomes with the use of microionized cartilage matrix allograft for the treatment of osteochondral lesions in the ankle. In this report we will present a unique case of navicular osteochondral lesion in a collegiate-level dancer which the patient suffered during a competition. The patient ultimately went on to have surgical intervention including curettage, bone marrow stimulation, and application of an extracellular matrix consisting of microionized cartilage combined with platelet-rich plasma. After a relatively short postoperative course, the patient subsequently returned to activity without reinjury or restrictions. Thirteen-month follow-up yielded an increase in American Orthopedic Foot and Ankle Society hindfoot score by 44 when compared to preoperatively. To our knowledge this is the first case of osteochondral lesion of the tarsal navicular treated with microionized cartilage matrix allograft. Excellent post-operative outcome with a relatively quick return to activity indicate this technique as a viable option for treatment of osteochondral lesions of the tarsal navicular.

Preparation and characterization of a novel drug-loaded Bi-layer scaffold for cartilage regeneration

“…[8][9][10] These treatments can improve some of the symptoms, but some adverse reactions are reported. 11,12 In recent years, tissue engineering (TE) has made considerable progress in obtaining functional articular cartilage. However, currently popular tissue engineering methods are difficult to restore damaged sites to their normal state because of their limited ability to rebuild anisotropic structures in native cartilage tissue.…”

Reconstruction of Navicular Osteochondral Lesions: Two Case Reports With Short-term Follow-up

“…Like OCLs of the talus, navicular OCLs can be managed nonoperatively with arch supports, immobilization, limited weightbearing, nonsteroidal antiinflammatory drugs, activity modifications, and physical therapy. 1 , 3 Described operative interventions for navicular OCLs include transplantation of iliac crest bone graft, 3 micronized cartilage matrix, 6 osteochondral autograft transplantation (OATS), 5 and flowable collagen with iliac crest bone marrow aspirate concentrate (BMAC) and fibrin glue. 4 In this report, we present 2 cases of navicular OCLs: one primary lesion treated with autologous bone grafting and cartilage resurfacing with lyophilized collagen II (BioCartilage; Arthrex, Naples, FL) and BMAC, and a second revision lesion after failed microfracture treated with OATS.…”

Osteochondral autograft transplantation for rare case of osteochondral lesion of the tarsal navicular in an adolescent athlete: A case report

“…The stress fracture was corrected using a cannulated screw. Recently, Togher et al 11 reported that OCL of the tarsal navicular was treated with microionized cartilage matrix allograft and revealed the excellent post-operative outcome.…”