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Knee Surgery, Sports Traumatology, Arthroscopy

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01-08-2013 | Ankle

Indications and limitations of osteochondral autologous transplantation in osteochondritis dissecans of the talus

Authors: Julia V. Woelfle, H. Reichel, M. Nelitz

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2013

Abstract

Purpose

Osteochondral autologous transplantation (OAT) from the ipsilateral femoral lateral condyle in osteochondritis dissecans (OD) of the talus has shown good clinical results in the past. To further define, indications and limitations of OAT various factors have been discussed which might influence the clinical outcome.

Methods

In this study, the clinical outcome of OAT of 32 patients (mean follow-up 29 months) was evaluated by means of the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, ankle pain on the visual analogue scale (VAS), and Hospital for Special Surgery (HSS) Patella score. We then analysed the statistical correlation between clinical outcome and various variables such as age, pre-existing osteoarthritis, or size of the lesion.

Results

Median AOFAS score was 86 (range 68–100), median ankle pain on VAS was 2.0 (range 0–5.5), and median HSS Patella score was 95 (range 35–100). Advanced age (above 40 years of age) was associated with a significantly lower HSS Patella score (80 vs. 97.5, p = 0.035). None of the other variables (obesity, pre-existing osteoarthritis, size of the lesion, necessity of malleolar osteotomy, localization of the lesion, and number of previous surgeries) influenced the clinical outcome adversely.

Conclusions

Osteochondral autologous transplantation in OD of the talus is a safe procedure with good clinical results. As advanced age is associated with higher donor-site morbidity, indication for OAT in older patients should be carefully considered. As none of the other variables affected the clinical outcome of OAT adversely, there is no contraindication for OAT, for example, in osteochondral lesions requiring more than one osteochondral grafts, lateral lesions, patients with BMI >25, pre-existing osteoarthritis, or failed previous surgery.

Level of evidence

IV.

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Title: Indications and limitations of osteochondral autologous transplantation in osteochondritis dissecans of the talus
Authors: Julia V. Woelfle
H. Reichel
M. Nelitz
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-013-2483-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Indications and limitations of osteochondral autologous transplantation in osteochondritis dissecans of the talus

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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