A Systematic Review on the Reporting of Outcome Data in Studies on Autologous Osteochondral Transplantation for the Treatment of Osteochondral Lesions of the Talus

Hannon, Charles P.; Baksh, Nikolas; Newman, Hunter; Smyth, Niall A.; Kennedy, John G.

doi:10.1177/1938640013484796

Cited by 9 publications

(10 citation statements)

References 46 publications

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“…The more common treatment strategies currently include osteochondral allograft procedures, osteochondral autograft transfer system (OATS) procedures, and classic and matrix-associated chondrocyte implantation (ACI, MACI) [20,21,32,39,55,56]. Even though the OATS procedure is regarded as an effective surgical management option with a 90% success rate reported in the literature, donor-site morbidity has been reported to occur relatively frequently with incidence rates ranging from 11 to 35% when the graft was harvested from the ipsilateral femoral condyle [13,16,19,23,24,26,44,57]. As an alternative to an OATS procedure harvesting the graft from the knee, an autologous osteoperiosteal cylinder graft can be harvested from the iliac crest.…”

Section: Introductory Remarksmentioning

confidence: 99%

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects

Kerkhoffs

Altink

Stufkens

et al. 2020

Oper Orthop Traumatol

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Objective Provision of a natural scaffold, good quality cells, and growth factors in order to facilitate the replacement of the complete osteochondral unit with matching talar curvature for large medial primary and secondary osteochondral defects of the talus. Indications Symptomatic primary and secondary medial osteochondral defects of the talus not responding to conservative treatment; anterior–posterior or medial–lateral diameter >10 mm on computed tomography (CT); closed distal tibial physis in young patients. Contraindications Tibiotalar osteoarthritis grade III; multiple osteochondral defects on the medial, central, and lateral talar dome; malignancy; active infectious ankle joint pathology. Surgical technique A medial distal tibial osteotomy is performed, after which the osteochondral defect is excised in toto from the talar dome. The recipient site is microdrilled in order to disrupt subchondral bone vessels. Then, the autograft is harvested from the ipsilateral iliac crest with an oscillating saw, after which the graft is adjusted to an exact fitting shape to match the extracted osteochondral defect and the talar morphology as well as curvature. The graft is implanted with a press-fit technique after which the osteotomy is reduced with two 3.5 mm lag screws and the incision layers are closed. In cases of a large osteotomy, an additional third tubular buttress plate is added, or a third screw at the apex of the osteotomy. Postoperative management Non-weight bearing cast for 6 weeks, followed by another 6 weeks with a walking boot. After 12 weeks, a CT scan is performed to assess consolidation of the osteotomy and the inserted autograft. The patient is referred to a physiotherapist. Results Ten cases underwent the TOPIC procedure, and at 1 year follow-up all clinical scores improved. Radiological outcomes showed consolidation of all osteotomies and all inserted grafts showed consolidation. Complications included one spina iliaca anterior avulsion and one hypaesthesia of the saphenous nerve; in two patients the fixation screws of the medial malleolar osteotomy were removed.

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Section: Introductory Remarksmentioning

confidence: 99%

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects

Kerkhoffs

Altink

Stufkens

et al. 2020

Oper Orthop Traumatol

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“…In up to 50% of ankle sprains, a secondary OLT has been described 1 2. In about 24% of cases, non-traumatic causes are reported 3. Causes of non-traumatic OLT may be vascular, genetic, morphological, endocrine or idiopathic 4 5…”

Section: Introductionmentioning

confidence: 99%

“…The OATS procedure has been proposed for lesions >150 mm 2 , cystic lesions or as an alternative after failure of the primary procedure (eg, in most cases BMS) 3 23. It addresses both the cartilage and bony defect at the same time, and additionally applies a hyaline cartilage coverage to the lesion.…”

Section: Introductionmentioning

confidence: 99%

Good clinical outcome after osteochondral autologous transplantation surgery for osteochondral lesions of the talus but at the cost of a high rate of complications: a systematic review

et al. 2016

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“…Upward displacement in the medial malleolus, chondral damage in the distal tibia joint surface and non-union or malunion of the osteotomy line are significant problems. 1,[2][3][4][5][6][7] The osteotomy not allowing the possibility of early weight-bearing, loss of workforce and delayed return to sports are other frequently encountered problems.…”

Section: Introductionmentioning

confidence: 99%

A triplanar osteotomy technique in arthroscopy-assisted ankle mosaicplasty

başal¹,

Aslan²

2020

J Orthop Surg (Hong Kong)

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Purpose: Osteochondral lesions of the talus are lesions that are seen particularly in the young age group and are often related to sports injuries and trauma. These lesions, which show late symptoms radiologically, can be determined in the early stages with magnetic resonance imaging. The aim of this study was to present a new osteotomy technique to reduce the complications of mosaicplasty surgery to a minimum and provide an early return to work. Methods: A total of 11 patients who had cartilage lesions due to osteochondritis dissecans in the medial aspect of the talus underwent mosaicplasty after a triplanar osteotomy. The dimensions of the lesion and the depth of the triplanar osteotomy were determined preoperatively. Coronal, sagittal and transverse cuts were made at the depth defined arthroscopically. Following the osteotomy, an osteochondral graft taken from the ipsilateral knee was placed in the prepared area. Osteotomy side was fixed with one or two cannulated screws following mosaicplasty. Results: With this technique, weight-bearing can be immediate in cases with no need for osteotomy in the joint surface. In cases including the joint surface, partial weight-bearing is permitted after 4 weeks and can be increased as tolerated. In the 11 cases treated with this technique, full weight-bearing was achieved at mean 5 weeks (range, 5-8 weeks). No shift (upward displacement of osteotomized fragment) or non-union was seen in any patient. Conclusion: With the triplanar osteotomy technique described here, potential shift complications can be reduced to a minimum. As only the lesion region is targeted, the osteochondral surface formed by the fracture is much less. Study design: Case Series; Level of Evidence, 4.which show late symptoms on X-ray views, can be determined in the early stages with magnetic resonance imaging (MRI). 6,8 Therefore, MRI is applied to many cases with radiological suspicion. More than 60% of OCD lesions are seen in the medial dome of the talus. 6,9 A 9-zone grid plan was described by Raikin et al. for the localization of

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A Systematic Review on the Reporting of Outcome Data in Studies on Autologous Osteochondral Transplantation for the Treatment of Osteochondral Lesions of the Talus

Abstract: Inconsistencies and an underreporting of data were apparent between studies, such that pooling was deemed not possible. An effort must be made by investigators to ensure that there is adequate reporting of data in studies of AOT treatment for OCLs of the talus.

Cited by 9 publications

References 46 publications

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects

Good clinical outcome after osteochondral autologous transplantation surgery for osteochondral lesions of the talus but at the cost of a high rate of complications: a systematic review

A triplanar osteotomy technique in arthroscopy-assisted ankle mosaicplasty

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