Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions of the talus

J Bone Joint Surg Br. 2006 May;88(5):614-9. doi: 10.1302/0301-620X.88B5.17306.

Abstract

The treatment of osteochondral lesions of the talus has evolved with the development of improved imaging and arthroscopic techniques. However, the outcome of treatment for large cystic type-V lesions is poor, using conventional grafting, debridement or microfracture techniques. This retrospective study examined the outcomes of 50 patients with a cystic talar defect who were treated with arthroscopically harvested, cored osteochondral graft taken from the ipsilateral knee. Of the 50 patients, 45 (90%) had a mean good to excellent score of 80.3 (52 to 90) in the Karlsson-Peterson Ankle Score, at a mean follow-up of 36 months (24 to 83). A malleolar osteotomy for exposure was needed in 26 patients and there were no malleolar mal- or nonunions. One patient had symptoms at the donor site three months after surgery; these resolved after arthroscopic release of scar tissue. This technique is demanding with or without a malleolar osteotomy, but if properly performed has a high likelihood of success.

MeSH terms

  • Adolescent
  • Adult
  • Ankle Injuries / complications
  • Ankle Injuries / physiopathology
  • Arthroscopy / methods
  • Bone Cysts / etiology
  • Bone Cysts / physiopathology
  • Bone Cysts / surgery
  • Bone Transplantation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteochondritis / etiology
  • Osteochondritis / physiopathology
  • Osteochondritis / surgery*
  • Osteotomy / methods
  • Reoperation
  • Retrospective Studies
  • Talus / surgery*
  • Treatment Outcome