Patient-Reported Outcomes After Structural Autograft for Large or Cystic Talar Dome Osteochondral Lesions.


Journal

Foot & ankle international
ISSN: 1944-7876
Titre abrégé: Foot Ankle Int
Pays: United States
ID NLM: 9433869

Informations de publication

Date de publication:
05 2020
Historique:
pubmed: 25 2 2020
medline: 21 7 2021
entrez: 25 2 2020
Statut: ppublish

Résumé

While smaller talar dome osteochondral lesions (OCLs) are successfully treated with bone marrow stimulation techniques, the optimal treatment for large or cystic OCLs remains controversial. This study tested the hypothesis that transferring structural autograft bone from the distal tibia to the talus for large or cystic OCLs improves pain and function. Thirty-two patients with large or cystic OCLs underwent structural bone grafting from the ipsilateral distal tibia to the talar dome. Patients were assessed with subjective patient-centered tools and objective clinical outcomes. Average age was 48.6 ± 14.9 years, and average follow-up was 19.5 ± 13.3 months. Average lesion area was 86.2 ± 23.5 mm At final follow-up, improvement compared to preoperative scores was seen in American Orthopaedic Foot & Ankle Society (65.4 ± 21.2 to 86.9 ± 15.0, This study demonstrates that structural bone graft harvested from the distal tibia transferred to the talus was a safe and effective treatment for large and cystic OCLs. Outcomes compare favorably to other described techniques for treatment of these injuries. Level IV, case series.

Sections du résumé

BACKGROUND
While smaller talar dome osteochondral lesions (OCLs) are successfully treated with bone marrow stimulation techniques, the optimal treatment for large or cystic OCLs remains controversial. This study tested the hypothesis that transferring structural autograft bone from the distal tibia to the talus for large or cystic OCLs improves pain and function.
METHODS
Thirty-two patients with large or cystic OCLs underwent structural bone grafting from the ipsilateral distal tibia to the talar dome. Patients were assessed with subjective patient-centered tools and objective clinical outcomes. Average age was 48.6 ± 14.9 years, and average follow-up was 19.5 ± 13.3 months. Average lesion area was 86.2 ± 23.5 mm
RESULTS
At final follow-up, improvement compared to preoperative scores was seen in American Orthopaedic Foot & Ankle Society (65.4 ± 21.2 to 86.9 ± 15.0,
CONCLUSION
This study demonstrates that structural bone graft harvested from the distal tibia transferred to the talus was a safe and effective treatment for large and cystic OCLs. Outcomes compare favorably to other described techniques for treatment of these injuries.
LEVEL OF EVIDENCE
Level IV, case series.

Identifiants

pubmed: 32088985
doi: 10.1177/1071100720907313
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

549-555

Auteurs

Todd Kim (T)

Palo Alto Medical Foundation, University of California, San Francisco, Burlingame, CA, USA.

Andrew Haskell (A)

Palo Alto Medical Foundation, University of California, San Francisco, Burlingame, CA, USA.

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