Bone-cartilage transplantation from the ipsilateral knee for chondral lesions of the talus

Treatment of osteochondral defects of the talus

“…176 Christel et al emphasized the diffi culty of restoring the curvature of the articular surface and reported less favorable clinical outcome in the ankle than in the knee, 79 whereas other authors published promising results. 23,31,144,176 Although hyaline cartilage of the donor area located in the knee is diff erent from the talar hyaline cartilage, there is no evidence this would represent a negative infl uence on the results. However, the integration of donor and recipient hyaline cartilage can be impaired because of diff erent mechanical properties and thickness.…”

“…143 Baltzer and Arnold reported malunion in one of 20 cases. 31 In their series, a slight reduction in plantar fl exion capacity remained aft er performing a medial malleolar osteotomy, while the range of motion aft er using an anterior arthrotomy (23 patients) became equal to the contralateral ankle joint. 31 Unfortunately, it is not possible to relate these outcomes to the direction of the osteotomy used, as the direction was only reported by Gaulrapp et al who applied 45º.…”

“…177 Although most reports show excellent results, the technique is associated with donor site morbidity, and a medial malleolar osteotomy is often required. 31,147,327 ACI is the implantation of in vitro cultured autologous chondrocytes, using a periosteal tissue cover after expansion of isolated chondrocytes. Despite excellent results reported by some investigators, 39,448 disadvantages include twostage surgery, high costs, and reported donor site morbidity.…”

Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

“…Osteoarthritis generally progresses over time, and, as with other major lower extremity joints, the treatment of choice for end-stage ankle osteoarthritis is surgical. In young patients, debridement, resurfacing, and realignment have limited indications [2][3][4][5] . Ankle arthrodesis and ankle replacement, currently the most commonly performed procedures, have recognized potential complications and long-term problems [6][7][8][9][10][11][12] .…”

Injuries to the Articular Cartilage

“…The osteochondral autologous transplantation method on the talus is used in traumatic and non-traumatic osteochondral defects of the talus, age greater than 16 years and less than 50 years, orthograde weight bearing, stable ligaments of the ankle joint, and absence of severe knee pain or injury in the past [18,19]. Open autologous osteochondral transplantation is performed by either anteromedial or anterolateral arthrotomy or lateral or medial malleolar osteotomy.…”