2015 ISAKOS Biennial Congress ePoster #129

Long Term Results of Osteochondral Transplantation of Talus with An Modified Malleolar Osteotomy Technique

Omer Faruk Taser, MD, Istanbul TURKEY
Sarper M. Cetinkaya, Istanbul TURKEY
Berkin Toker, MD, Istanbul TURKEY
Vahit Emre Özden, MD, Istanbul TURKEY
Göksel Dikmen, MD, Istanbul TURKEY
Mustafa Sengün, MD, Istanbul TURKEY

Acibadem Fulya Hospital, Department of Orthopedics, Sports Medicine Center, Istanbul, TURKEY

FDA Status Cleared

Summary: Despite demanding surgical technique we can admit osteochondral autograft transplantation is a gold standart treatment option for the talar osteochondral lesions regarding the potential donor site morbidity.

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Abstract:

Purpose

Our aim is to evaluate the long term results of mosaicplasty of talar lesions performed with an modified osteotomy technique.
Materials and Method :
Between August 2002 and October 2008, 20 consecutive patients (21 ankles) with talar osteochondral lesions were treated with the osteochondral autograft transfer system ( Arthrex, Naples, FL ). We had 11 men and 9 women patients with a mean age of 33,5 years ( range, 16-56). The mean follow up period was 91,9 months( range , 58 to 126 month). From 21 ankles 20 of them had medial talar osteochondral lesions while one of them had lateral lesion. We performed an modified sulcus groove osteotomy which provides a better exposure for medial and central lesions. Patients clinical functions were evaluated preoperatively and postoperatively at the last follow up according to American Orthopaedic Foot and Ankle Society ( AOFAS) ankle hindfoot scale and for pain Visual Analogue Score ( VAS ). Lysholm and Tegner activity scale were used to determine the knee activity levels.

Results

The preoperative average AOFAS were significantly improved from 60,4 ( range, 48 to 70 ) to 82,1 ( range , 60 to 90 ) at the last follow up (p< 0,05). The mean ankle VAS score had significantly decreased from preoperative of 6,25 (range, 5 to 7) to 2 (range, 0-4). We had excellent results in 15 ankle, good result in 5 ankle and poor result in one ankle. The mean Lysholm score for this group is 89,7. We classified the scores showing excellent results ( 95-100) for 9 patients, good results ( 84-94) for 6 patients, fair results ( 65-83) for 6 patients. Two patients undergone revisions after osteochondral autograft transfer after at an average 6,5 years follow-up. One of them undergone arthrodesis because of recurrent pain and arthritis after six years and second look arthroscopy was performed after 7 years for ankle impingement case. Recurrent knee pain at the donor site of osteochondral autograft was observed in six patients (%28).

Conclusion

This study shows the longest outcome in talar osteochondral lesions in the literature. Despite demanding surgical technique we can admit osteochondral autograft transplantation is a gold standart treatment option for the talar osteochondral lesions regarding the potential donor site morbidity.