Ankle Joint Cartilage Pathology and Repair

Shimozono, Yoshiharu; Fansa, Ashraf M.; Kennedy, John G.

doi:10.1007/978-3-030-57382-9_30

Cited by 1 publication

(2 citation statements)

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“…Similarly, our results using PJCA with bone grafting also suggest treating the pathology of the underlying bony lesion to provide a scaffold for the regeneration of stable subchondral bone is equally as important as repairing the damaged cartilage. 1,6 To date, there have been no formal studies indicating what minimal depth 15 In addition to supporting, maintaining, and repairing the articular cartilage, the subchondral bone also aids in absorbing and distributing shock and mechanical stresses through the tibiotalar joint. 16 The subchondral bone has also been shown to communicate with the cartilage through various signaling pathways in order to better distribute stress and lesions of the bone and can contribute to the pain experienced with an OLT.…”

Section: Discussionmentioning

confidence: 99%

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Open Treatment of Osteochondral Lesions of the Talus With Bone Grafting and Particulated Juvenile Cartilage Allografting

Dasari

Länger

Parshall

et al. 2021

Foot & Ankle Specialist

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Background: Large cystic osteochondral lesions of the talus (OLT) are challenging pathological conditions to treat, but particulated juvenile cartilage allografts (PJCAs) supplemented with bone grafts are a promising therapeutic option. The purpose of this project was to further elucidate the role of PJCA with concomitant bone autografts for treating large cystic OLTs with extensive subchondral bone involvement (greater than 150 mm2 in area and/or deeper than 5 mm). Methods: We identified 6 patients with a mean OLT area of 307.2 ± 252.4 mm2 and a mean lesion depth of 10.85 ± 6.10 mm who underwent DeNovo PJCA with bone autografting between 2013 and 2017. Postoperative outcomes were assessed with radiographs, Foot and Ankle Outcome Scores (FAOS), and visual pain scale scores. Results: At final follow-up (27.0 ± 12.59 weeks), all patients had symptomatic improvement and incorporation of the graft on radiographs. At an average of 62 ± 20.88 months postoperatively, no patients required a revision surgery. All patients contacted by phone in 2018 and 2020 reported they would do the procedure again in retrospect and reported an improvement in their symptoms relative to their preoperative state, especially with pain and in the FAOS activities of daily living subsection (91.93 ± 9.04 in 2018, 74.63 ± 26.86 in 2020). Conclusion: PJCA with concomitant bone autograft is a viable treatment option for patients with large cystic OLTs. Levels of Evidence: Level IV

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Section: Discussionmentioning

confidence: 99%

“…16 The subchondral bone has also been shown to communicate with the cartilage through various signaling pathways in order to better distribute stress and lesions of the bone and can contribute to the pain experienced with an OLT. 15 Thus, to best treat a large OLT, a technique should be used that restores both the bone and cartilage.…”

Section: Discussionmentioning

confidence: 99%