2025 ISAKOS Biennial Congress ePoster
Outcomes Following Autologous Osteochondral Transplantation For Osteochondral Lesions Of The Talus At A Minimum Of 10-Year Follow-Up: A Retrospective Review
James J. Butler, MB, BCh, New York, New York UNITED STATES
Guillaume Robert, Lille FRANCE
Jari Dahmen, MD, BSc, Amsterdam NETHERLANDS
Charles C. Lin, BSE, New York, New York UNITED STATES
Sebastian Krebsbach, BS, New York UNITED STATES
Joseph Robin, MD, New York, NY UNITED STATES
Alan P. Samsonov, BS, New York, NY UNITED STATES
John G. Kennedy, MD, MCh, MMSc, FFSEM, FRCS (Orth), New York UNITED STATES
NYU Langone Health, New York, NY, UNITED STATES
FDA Status Not Applicable
Summary
Autologous osteochondral transplantation for osteochondral lesions of the talus demonstrates a 94.9% survival rate and significant improvement in clinical outcomes over a minimum of 10 years, though larger lesion sizes are associated with worse outcomes.
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Abstract
Introduction
The purpose of this study was to evaluate outcomes following autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesions of the talus (OLT) at a minimum of 10-year follow-up.
Methods
Retrospective chart review identified patients who underwent AOT for the treatment of OLT. Pre-operative magnetic resonance imaging (MRI) scans were obtained in all patients. Clinical outcomes assessed included: pre- and post-operative foot and ankle outcome score (FAOS), visual analog scale (VAS), patient satisfaction, complications, failures and secondary surgical procedures.
Results
Thirty-nine patients with a mean lesion size was 122.3±64.1 mm2 and mean follow-up time of 138.9±16.9months were included. The mean FAOS scores improved from a preoperative score of 51.9±16.0 to 75.3±21.9 (p< 0.001). Increasing lesion size was variable associated with inferior FAOS scores (R2=0.2228). There was statistically significant higher mean T2 relaxation values at the superficial layer at the site of the AOT graft (42.9±5.2ms) compared to the superficial layer of the adjacent native cartilage (35.8±3.8ms) (p< 0.001). Seventeen complications (43.6%) were observed, the most common of which was anterior ankle impingement (25.6%). There were 2 failures (5.1%), both of which had a history of prior bone marrow stimulation via microfracture and post-operative cysts identified on MRI.
Discussion And Conclusion
This retrospective review found that AOT for the treatment of large OLTs produced a 94.9% survival rate at a minimum of 10-year follow-up. Increasing lesion size was associated with inferior clinical outcomes. The findings of this study indicates that AOT is a viable long-term surgical strategy for the treatment of large OLTs.