• Arthroscopy · Feb 2005

    Bone-cartilage transplantation from the ipsilateral knee for chondral lesions of the talus.

    • Axel W A Baltzer and Juergen P Arnold.
    • Center for Orthopaedic Surgery, Molecular Orthopaedics, and Neurosurgery, Düsseldorf, Germany. axel.baltzer@gmx.de
    • Arthroscopy. 2005 Feb 1;21(2):159-66.

    PurposeWe present a prospective analysis to review talus dome chondral and osteochondral lesions treated with autogenous bone-cartilage transplantation harvested from the ipsilateral knee since 1998. The clinical outcome of osteochondral defects is investigated by using a method for resurfacing that supplies hyaline cartilage. The outcome analysis also considers defect size and the number of transplanted osteochondral cylinders.Type Of StudyProspective analysis of a case series.MethodsIncluded in the study were 43 patients with ankle joint pain resulting from osteochondritis dissecans stage III-IV (n = 22), post-traumatic cartilage defects (n = 16), and focal osteoarthritis (n = 5). The mean age of this group was 31.2 years; there were 30 male and 13 female patients. To carry out the osteochondral resurfacing procedure, anteromedial or anterolateral arthrotomy (23 cases) or medial malleolar osteotomy (20 cases) of the distal tibia was performed. The osteochondral autograft transfer system (OATS; Arthrex, Naples, FL) was used for transplantation. The follow-up examinations were performed after 3 months (clinical, radiological), after 6 months (clinical, radiological), after 9 months (clinical, radiological, hardware removal, and second-look arthroscopy), after 12 months, and every following year (clinical, radiological, magnetic resonance imaging). The follow-up of 11 patients was greater than 2 years (maximum, 4.5 years), for 8 patients 1 to 2 years, for 12 patients 6 to 12 months, and for another 12 patients 0 to 6 months. The results have been validated by the scores of Evanski and Waugh score and Mazur et al.ResultsThe mean pain intensity measured by visual analogue scale (0 to 10, with 10 representing the worst imaginable pain) reduced from 4.4 to 2.3 after 6 months (n = 34), to 1.6 after 1 year (n = 23), and after 2 years to 1.1 (n = 14). Patients reported a significantly improved range of motion of the ankle compared with their preoperative status. The smaller the diameter of the transplants and the smaller the number of transplants used, the better were the results in pain reduction and postoperative range of motion. The Evanski and Waugh score improved from 52 to 88 points and the score described by Mazur et al. from 53 to 90 of 100 possible points. All medial osteotomies were healed clinically and radiographically. All grafts showed bony integration in the talus as seen in the radiographs and by magnetic resonance imaging. Second-look arthroscopy found integration of the osteocartilaginous graft with surrounding cartilage within the first year. A series of needle biopsies showed hyaline structure.ConclusionsAutogenous osteochondral transplantation of the talus using ipsilateral knee osteochondral grafts is a very promising surgical procedure to treat local cartilage lesions of the ankle joint.Level Of EvidenceLevel IV.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.