Clinical Outcomes of Osteochondral Lesions of the Talus With Large Subchondral Cysts Treated With Osteotomy and Autologous Chondral Grafts: Minimum 2-Year Follow-up and Second-Look Evaluation.
autologous chondral graft
cyst
malleolus osteotomy
osteochondral lesion
talus
Journal
Orthopaedic journal of sports medicine
ISSN: 2325-9671
Titre abrégé: Orthop J Sports Med
Pays: United States
ID NLM: 101620522
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
15
02
2020
accepted:
12
03
2020
entrez:
13
8
2020
pubmed:
13
8
2020
medline:
13
8
2020
Statut:
epublish
Résumé
Osteochondral lesions of the talus (OLTs) with large subchondral cysts are challenging to treat. To determine the safety and efficacy of autologous chondral grafting and malleolus osteotomy for treating OLTs associated with large subchondral cysts. Case series; Level of evidence, 4. A total of 19 patients underwent autologous chondral grafting and malleolus osteotomy. We obtained the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, and magnetic resonance observation of cartilage repair tissue (MOCART) scores at 1 and 2 years postoperatively. The International Cartilage Repair Society (ICRS) score was collected 2 years postoperatively during second-look arthroscopic surgery. In all patients, the osteotomy site healed without nonunion or malunion. Only 1 patient developed joint space narrowing. No donor site complications occurred. The mean AOFAS score significantly improved at 1 year (from 72.8 ± 4.8 preoperatively to 93.7 ± 4.6; Osteotomy combined with autologous osteochondral transplantation provided good functional outcomes in patients with OLTs and large subchondral cysts. Second-look arthroscopic surgery showed healthy cartilage healing.
Sections du résumé
BACKGROUND
BACKGROUND
Osteochondral lesions of the talus (OLTs) with large subchondral cysts are challenging to treat.
PURPOSE
OBJECTIVE
To determine the safety and efficacy of autologous chondral grafting and malleolus osteotomy for treating OLTs associated with large subchondral cysts.
STUDY DESIGN
METHODS
Case series; Level of evidence, 4.
METHODS
METHODS
A total of 19 patients underwent autologous chondral grafting and malleolus osteotomy. We obtained the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, and magnetic resonance observation of cartilage repair tissue (MOCART) scores at 1 and 2 years postoperatively. The International Cartilage Repair Society (ICRS) score was collected 2 years postoperatively during second-look arthroscopic surgery.
RESULTS
RESULTS
In all patients, the osteotomy site healed without nonunion or malunion. Only 1 patient developed joint space narrowing. No donor site complications occurred. The mean AOFAS score significantly improved at 1 year (from 72.8 ± 4.8 preoperatively to 93.7 ± 4.6;
CONCLUSION
CONCLUSIONS
Osteotomy combined with autologous osteochondral transplantation provided good functional outcomes in patients with OLTs and large subchondral cysts. Second-look arthroscopic surgery showed healthy cartilage healing.
Identifiants
pubmed: 32782905
doi: 10.1177/2325967120937798
pii: 10.1177_2325967120937798
pmc: PMC7388127
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2325967120937798Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
One or more of the authors has declared the following potential conflict of interest or source of funding: This study was supported by grants from the Health and Family Planning Commission of Shenzhen Municipality (SZXJ2018085), Sanming Project of Medicine of Shenzhen (SZSM201612078), Medical Scientific Research Foundation of Guangdong Province (A2017202), and Natural Science Foundation of Guangdong Province (2017A030310616). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
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