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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-06-2014 | Ankle

Bony periosteum-covered iliac crest plug transplantation for severe osteochondral lesions of the talus: a modified mosaicplasty procedure

Authors: André Leumann, Victor Valderrabano, Martin Wiewiorski, Alexej Barg, Beat Hintermann, Geert Pagenstert

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2014

Abstract

Purpose

This study reports first evidence of a modified procedure for osteochondral autologous transplantation where bony periosteum-covered plugs are harvested at the iliac crest and transplanted into the talar osteochondral lesion.

Methods

Thirteen out of 14 patients, average age 39.6 (SD 14.4) years, were followed clinically and radiographically for a median of 25 (24–28) months (minimal follow-up, 24 months).

Results

For these 13 patients, the American Orthopaedic Foot and Ankle Society hindfoot score increased from 47 (SD 11) points pre-operatively, to 81 (SD 14) points postoperatively (p < 0.0001). The average pain score decreased from 6.6 (SD 1.3) points pre-operatively, to 1.4 (SD 1.9) points postoperatively (p < 0.0001). Seven patients returned to sports activity. Radiographically good plug osteointegration was observed in nine out of 11 ankles. Follow-up arthroscopy showed fibrous cartilage in four ankles, periosteum hypertrophy in five ankles, and partial or total missing of coverage of the bone in three ankles. Three revision surgeries had to be performed.

Conclusions

This modified mosaicplasty might be recommended for severe and recurrent osteochondral lesions of the talus and may lead to restoration of the subchondral bone stock, formation of fibro-cartilage, and stable joint function.

Level of evidence

IV.

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Title: Bony periosteum-covered iliac crest plug transplantation for severe osteochondral lesions of the talus: a modified mosaicplasty procedure
Authors: André Leumann
Victor Valderrabano
Martin Wiewiorski
Alexej Barg
Beat Hintermann
Geert Pagenstert
Publication date: 01-06-2014
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-013-2604-y

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Bony periosteum-covered iliac crest plug transplantation for severe osteochondral lesions of the talus: a modified mosaicplasty procedure

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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