Summary

An autologous osteoperiosteal cylinder graft from the medial tibia is effective for treating large cystic medial OCLs of the talus and has a low rate of complications.

Abstract

Purpose

To investigate the clinical and radiological outcomes of an autologous osteoperiosteal cylinder graft from the medial tibia for the treatment of large cystic medial osteochondral lesions (OCLs) of the talus. Methods: The study included 38 patients with large cystic medial OCLs. All underwent medial malleolus osteotomy, excision and curettage of the defect site, followed by transplantation with an autologous osteoperiosteal cylinder graft from the medial tibia. Patients were evaluated preoperatively and after a minimum of 24 months (mean, 46.8 months; range, 24 to 84 months) postoperatively using the visual analog scale (VAS), the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, the Ogilvie-Harris scale and magnetic resonance imaging (MRI) of the ankle. Results: The mean VAS score decreased from 5.60±1.12 to 1.10±1.00 points (P=0.000), and the mean AOFAS score increased from 50.00±7.84 to 88.00±6.32 points (P=0.000). The mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was 64.00±5.07 points. According to the Ogilvie-Harris scale, 19 cases were rated as “excellent”, 14 cases as “good”, 5 cases as “fair”, and 0 cases as “poor”. No complications were observed. Conclusion: An autologous osteoperiosteal cylinder graft from the medial tibia is effective for treating large cystic medial OCLs of the talus and has a low rate of complications.