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European Journal of Orthopaedic Surgery & Traumatology

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31-08-2023 | Arthroscopy | Original Article

Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation ± Calcaneal Autograft: A Cohort Study

Authors: Joseph E. Manzi, Kshitij Manchanda, Matthew H. Nasra, Suleiman Y. Sudah, Carlo Coladonato, Theodore Quan, Mark Wishman, Jay Moran, Daniel P. Murray, Cary B. Chapman

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2024

Abstract

Background

Osteochondral lesions of the talus (OCLT) are common injuries that can be difficult to treat. To date, long-term patient reported outcome measures (PROMs) of patients with particulated juvenile allograft cartilage implantation with or without calcaneal autograft have not been compared.

Methods

Thirteen patients with difficult to treat OCLTs underwent arthroscopic-assisted implantation of particulated juvenile allograft cartilage (DeNovo NT®) with or without autogenous calcaneal bone grafting by a single surgeon. Calcaneal bone graft use was determined by lesion size > 150 mm² and/or deeper than 5 mm. Patients were evaluated using physical examination, patient interviews, and PROMs.

Results

When comparing patients in regards to calcaneal bone graft implantation, no difference in age, BMI, pre-operative PROMs, or follow-up was noted, however, calcaneal bone graft patients did have a significantly larger lesion size (188.5 ± 50.9 vs. 118.7 ± 29.4 mm² respectively; p value = 0.027). VAS and FAAM ADL scores during final follow-up improvement did not significantly differ between cohorts. The FAAM Sports score improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.032). The AOFAS score improvement did not differ between cohorts (p value = 0.944), however, the SF-36 PCS improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.038). No intraoperative/perioperative complications were observed with calcaneal bone grafting.

Conclusion

While patients followed over the course of ~ 8 years after implantation of particulated juvenile allograft cartilage (DeNovo NT®) with/without autogenous calcaneal bone graft had positive post-operative PROMs, patients without calcaneal bone graft had significantly greater improvement in functional outcome scores. Whether these differences are due to graft incorporation or larger lesion size is unclear.

Level of Evidence

III, retrospective cohort study.

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Title: Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation ± Calcaneal Autograft: A Cohort Study
Authors: Joseph E. Manzi
Kshitij Manchanda
Matthew H. Nasra
Suleiman Y. Sudah
Carlo Coladonato
Theodore Quan
Mark Wishman
Jay Moran
Daniel P. Murray
Cary B. Chapman
Publication date: 31-08-2023
Publisher: Springer Paris
Keywords: Arthroscopy
Arthroscopy
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-023-03642-7

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Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation ± Calcaneal Autograft: A Cohort Study

Abstract

Background

Methods

Results

Conclusion

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of Evidence

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