2023 ISAKOS Biennial Congress Paper
Talar Osteoperiostic Grafting From The Iliac Crest (Topic): Return To Sports Outcomes Of A Novel Press-Fit Surgical Treatment For Large Talar Osteochondral Lesions
Jari Dahmen, MD, BSc, Amsterdam NETHERLANDS
Quinten G.H. Rikken, BSc., Amsterdam NETHERLANDS
Sjoerd A.S. Stufkens, MD, PhD, Amsterdam NETHERLANDS
Gino M. M. J. Kerkhoffs, MD, PhD, Prof., Amsterdam NETHERLANDS
Amsterdam UMC, Amsterdam, Noord-Holland NH, NETHERLANDS
FDA Status Not Applicable
Summary
The TOPIC procedure for large osteochondral lesions of the talus resulted in a 90% of return to any level of sports rate, a 72% return to pre-injury of sports rate, and a 30% of return to performance rate.
Abstract
Purpose
The purpose of this study was to evaluate the sports outcomes of a new press-fit OATS technique for large primary and secondary talar osteochondral lesions of the talus (OLTs), Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC).
Methods
The study population included amateur and professional athletes with a talar osteochondral lesion size of at least 10 mm in diameter as measured anteroposteriorly or mediolaterally. The surgical intervention in question was the Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) procedure, which was performed in a press-fit way. Sports outcomes at a minimum of 24 months included return to sports rates, level (return to any level of sports, return to pre-injury levels of sports, and return to performance), including corresponding return to sports times of the aforementioned levels.
Results
A total of 40 athletes, including 2 professional athletes, were assessed. All patients were available for the follow-up at 24 months post-operatively. The mean follow-up duration was 24 months (SD 4.5). The mean lesion size was 356 mm2. Return to any level of sports rate was 90% (95% CI 83 – 95) with an associated time of 8.4 months (SD 2.3). Return to pre-injury level of sports rate was 72% (95% CI 60 – 83) with an associated time of 9.5 months (SD 3.0). Return to performance was 30% (95% CI 20 – 40) with an associated return to performance time of 12 months (SD 4.6).
Conclusions
The TOPIC procedure for large osteochondral lesions of the talus resulted in a 90% of return to any level of sports rate, a 72% return to pre-injury of sports rate, and a 30% of return to performance rate. Long-term results are necessary to evaluate whether the TOPIC procedure stands the test of time from both a clinical and sports outcome perspective in order to be considered the treatment of choice for large OLTs at long-term follow-up.