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Clinical Orthopaedics and Related Research®

Published in:

01-08-2011 | Clinical Research

Does Fresh Osteochondral Allograft Transplantation of Talar Osteochondral Defects Improve Function?

Authors: Gregory C. Berlet, MD, Christopher F. Hyer, DPM, Terrence M. Philbin, DO, Jodi F. Hartman, MS, Michelle L. Wright, MPH

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2011

Abstract

Background

Fresh osteochondral allograft transplantation can be used to replace talar osteochondral defects (OCDs) with single bulk osteochondral graft. While limited studies report improvement of function, improvement in quality of life and radiographic durability is unknown.

Questions/purpose

We therefore determined if this technique improved function, increased quality of life, and provided durable graft stability radiographically and by MRI.

Patients and Methods

We prospectively followed 19 patients (19 OCDs). We excluded seven patients (four with insufficient followup, two who were lost to followup, and one with graft failure), leaving 12 patients with a minimum followup of 2 years (average, 3.3 years; range, 2.0–4.6 years). Functional and quality of life outcomes were quantified using the American Orthopaedic Foot and Ankle Society (AOFAS) score and the SF-12 Health Survey. Graft incorporation and stability were assessed through radiographs and MRI.

Results

Mean total AOFAS scores (61 ± 9 to 79 ± 6), pain subscores (17 ± 8 versus 26 ± 5), and function subscores (34 ± 3 versus 42 ± 4) improved from preoperatively to last followup. We observed no improvements of the physical and mental health components of the SF-12 Health Survey from preoperatively to last followup. At last followup, three of the 12 grafts had radiolucencies, four had edema, one failed to incorporate, and none had subsidence. One of the 19 patients in the overall series underwent graft revision.

Conclusions

Patients with talar OCDs can expect functional improvement after this technique. The majority will have stable grafts at least short term. Larger studies with longer followup are needed to determine if this procedure substantially improves quality of life, if graft radiolucencies and edema have any long-term implications, and whether the grafts are durable.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Does Fresh Osteochondral Allograft Transplantation of Talar Osteochondral Defects Improve Function?
Authors: Gregory C. Berlet, MD
Christopher F. Hyer, DPM
Terrence M. Philbin, DO
Jodi F. Hartman, MS
Michelle L. Wright, MPH
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 8/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-011-1813-2

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Springer Medicine

Does Fresh Osteochondral Allograft Transplantation of Talar Osteochondral Defects Improve Function?

Abstract

Background

Questions/purpose

Patients and Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Questions/purpose

Patients and Methods

Results

Conclusions

Level of Evidence

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