Outcomes of talar dome osteochondral defect repair using osteocartilaginous autografts: 37 cases of Mosaicplasty®

Orthop Traumatol Surg Res. 2015 Feb;101(1):97-102. doi: 10.1016/j.otsr.2014.11.006. Epub 2015 Jan 16.

Abstract

Background: The indications of osteochondral autograft implantation using the Mosaicplasty(®) technique were only recently extended to osteochondral lesions of the talus (OLT), a site for which no medium- or long-term outcome data are available. Our objective here was to evaluate medium-term outcomes in case-series of patients who underwent Mosaicplasty(®) for OLT repair.

Hypothesis: Mosaicplasty(®) provides good medium-term outcomes with low morbidity when used for OLT repair.

Patients et methods: We retrospectively reviewed cases of Mosaicplasty(®) for OLT repair, performed in combination with malleolar osteotomy on the side of the OLT, at either of two centres, between 1997 and 2013. Pre-operative clinical data were collected from the medical records and all patients were re-evaluated. We studied 37 patients with a mean age of 33 years.

Results: Mean follow-up at re-evaluation was 76 months. Mean AOFAS score at re-evaluation was 83 (range, 9-100). A work-related cause to the OLT was associated with significantly poorer outcomes (P=0.01). AOFAS values were significantly better in patients whose OLT size was 0.5 to 1cm(2). The Ogilvie-Harris score at last follow-up was good or excellent in 78% of patients. No patient experienced morbidity related to the malleolar osteotomy. Persistent patellar syndrome was noted in 6 patients.

Discussion: In our case-series, Mosaicplasty(®) for OLT repair provided good medium-term outcomes in 78% of patients. Nevertheless, the donor-site morbidity should be borne in mind. Mosaicplasty(®) deserves to be viewed as a reference standard method for OLT repair.

Level of evidence: IV, retrospective study.

Keywords: Cartilage; Graft; Mosaicplasty(®); Osteochondritis; Talus.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Autografts
  • Bone Transplantation / methods*
  • Cartilage / transplantation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Osteochondritis / surgery*
  • Osteotomy / methods*
  • Reconstructive Surgical Procedures / methods*
  • Retrospective Studies
  • Talus / surgery*
  • Young Adult