Treatment of Large Cystic Medial Osteochondral Lesions of the Talus With Autologous Osteoperiosteal Cylinder Grafts

Hu, Yuelin; Guo, Qinwei; Chen, Jiao; Yu, Mengxue; Jiang, Dong; Wang, Jia‐Ning; Zheng, Zhuozhao

doi:10.1016/j.arthro.2013.05.014

Cited by 40 publications

(67 citation statements)

References 24 publications

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“…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%

No superior treatment for primary osteochondral defects of the talus

Dahmen

Lambers

Reilingh

et al. 2017

Knee Surg Sports Traumatol Arthrosc

141

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%

No superior treatment for primary osteochondral defects of the talus

Dahmen

Lambers

Reilingh

et al. 2017

Knee Surg Sports Traumatol Arthrosc

141

131

View full text Add to dashboard Cite

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“…There are, however, some concerns related to the long-term morbidity of the knee, especially in younger people 25 41. Alternative donor site locations have been used with good functional outcomes 7 26 27 33 47. A crucial concern of OATS was long-term morbidity that might occur in donor and lesion locations.…”

Section: Discussionmentioning

confidence: 99%

Good clinical outcome after osteochondral autologous transplantation surgery for osteochondral lesions of the talus but at the cost of a high rate of complications: a systematic review

et al. 2016

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“…The number and size of grafts were determined intraoperatively with a sizing guide. Grafts with diameters of 6–10 mm have been commonly used in our previous studies 15. Lesions greater than 11 mm diameter required two grafts placed side by side in a figure-of-8 formation or ‘nested’, which minimised fibrocartilage fill of adjacent graft space 19 20…”

Section: Methods and Designmentioning

confidence: 99%

“…According to Hu et al ,15 with the anterior superior iliac spine exposed, the periosteum will be preserved. A harvester tube with an 8 mm or 10 mm inner diameter will be driven deeply and perpendicularly 2 cm proximal to the anterior superior iliac spine, and then the osteoperiosteal graft will be harvested.…”

Section: Methods and Designmentioning

confidence: 99%

“…Autologous osteochondral transplantation has been viewed as an alternative choice for treating these lesions, but the high proportion donor-site morbidity that ranged from 6.7% to 10.8% and the size of osteochondral grafts have limited the application of this technique 14. Thus, Hu et al 15 have tried to repair large cystic OLTs with autologous osteoperiosteal grafts because of their low cost and the absence of donor-site morbidity in the normal knee joint; this procedure has shown favourable clinical outcomes and satisfactory incorporation of grafts into the adjacent tissue.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of autologous osteoperiosteal cylinder and osteochondral graft transplantation in the treatment of large cystic osteochondral lesions of the talus (OLTs): a protocol for a non-inferiority randomised controlled trial

et al. 2020

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IntroductionLarge cystic osteochondral lesions of the talus (OLTs) have been shown to have inferior clinical outcomes after reparative techniques such as bone marrow stimulation. Autologous osteochondral transplantation has been viewed as an alternative choice for treating these lesions, but donor-site morbidity has limited its application. Excellent clinical outcomes have been shown in repairing these types of lesions with autologous osteoperiosteal grafts, and these outcomes are achieved at a low cost and without donor-site morbidity in the normal knee joint. This will be the first randomised controlled trial to compare the two surgical techniques, and recommendations for the treatment of patients with large cystic OLTs will be provided.Methods and analysisA non-inferiority randomised controlled trial will be conducted. A total of 70 participants with clinically diagnosed large cystic OLTs will be randomly allocated to either the experimental group or the control group at a ratio of 1:1. The experimental group will be treated with autologous osteoperiosteal cylinder graft transplantation, while the control group will be treated with autologous osteochondral transplantation. The primary outcome measure will be the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score and the Short Form 12 (SF-12) questionnaire. Secondary outcome measures will include the secondary arthroscopy International Cartilage Repair Society score, the Magnetic Resonance Observation of Cartilage Repair Tissue score, the Tegner activity level score, the visual analogue scale, routine X-rays, CT and complications. These parameters will be evaluated preoperatively, as well as at 3, 6, 12, 24, 36 and 60 months postoperatively. In this trial, we hypothesised that both procedures offer good results for the treatment of patients with large cystic OLTs, and occurrence of donor-site morbidity in autologous osteoperiosteal cylinder graft transplantation group is less than that in autologous osteochondral transplantation group.Ethics and disseminationThe current study was approved by the board of research ethics of Peking University Third Hospital Medical Science Research Ethics Committee. The results of this study will be presented at national and international conferences and published in peer-reviewed journals.Trial registration numberNCT03347877.

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Treatment of Large Cystic Medial Osteochondral Lesions of the Talus With Autologous Osteoperiosteal Cylinder Grafts

Cited by 40 publications

References 24 publications

No superior treatment for primary osteochondral defects of the talus

No superior treatment for primary osteochondral defects of the talus

Good clinical outcome after osteochondral autologous transplantation surgery for osteochondral lesions of the talus but at the cost of a high rate of complications: a systematic review

Comparison of autologous osteoperiosteal cylinder and osteochondral graft transplantation in the treatment of large cystic osteochondral lesions of the talus (OLTs): a protocol for a non-inferiority randomised controlled trial

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