Clinical Outcome and Magnetic Resonance Imaging after Osteochondral Autologous Transplantation in Osteochondritis Dissecans of the Talus

Woelfle, Julia V.; Reichel, Heiko; Javaheripour-Otto, Katayoun; Nelitz, Manfred

doi:10.1177/1071100712467433

Cited by 31 publications

(23 citation statements)

References 29 publications

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“…Of the complications related to the ankle (figure 3), subchondral oedema and incongruity of the ankle joint were not correlated with clinical symptoms and did not affect the clinical outcome 6 39 40. Soft tissue impingement, surface incongruity of transplants and the uncovered area between plugs, however, did affect clinical outcome 36 41 51.…”

Section: Resultsmentioning

confidence: 98%

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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Section: Resultsmentioning

confidence: 98%

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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“…Osteochondral transplantation was the most commonly described procedure after failed primary surgery as eight studies were identified describing 135 patients corresponding to 137 treated ankles [ 1 , 5 , 12 , 16 , 20 , 22 , 45 , 60 ]. Five of these studies were retrospective in design, and the other three were prospectively described case series.…”

Section: Resultsmentioning

confidence: 99%

“…The included studies described different osteo(chondral) transplantation techniques. Three articles investigated a procedure with a classic osteochondral autograft transfer system (OATS) [ 1 , 16 , 60 ]. Two studies described a (autogenous) mosaicplasty procedure, which is similar to an OATS technique but uses multiple grafts creating a mosaic pattern [ 12 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

No superior surgical treatment for secondary osteochondral defects of the talus

Lambers

Dahmen

Reilingh

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this systematic review was to identify the most effective surgical treatment for talar osteochondral defects after failed primary surgery.Methods A literature search was conducted to find studies published from January 1996 till July 2016 using PubMed (MEDLINE), EMBASE, CDSR, DARE and CENTRAL. Two authors screened the search results separately and conducted quality assessment independently using the Newcastle–Ottawa scale. Weighted success rates were calculated. Studies eligible for pooling were combined.ResultsTwenty-one studies with a total of 299 patients with 301 talar OCDs that failed primary surgery were investigated. Eight studies were retrospective case series, twelve were prospective case series and there was one randomized controlled trial. Calculated success percentages varied widely and ranged from 17 to 100%. Because of the low level of evidence and the scarce number of patients, no methodologically proper meta-analysis could be performed. A simplified pooling method resulted in a calculated mean success rate of 90% [CI 82–95%] for the osteochondral autograft transfer procedure, 65% [CI 46–81%] for mosaicplasty and 55% [CI 40–70%] for the osteochondral allograft transfer procedure. There was no significant difference between classic autologous chondrocyte implantation (success rate of 59% [CI 39–77%]) and matrix-associated chondrocyte implantation (success rate of 73% [CI 56–85%]).Conclusions Multiple surgical treatments are used for talar OCDs after primary surgical failure. More invasive methods are administered in comparison with primary treatment. No methodologically proper meta-analysis could be performed because of the low level of evidence and the limited number of patients. It is therefore inappropriate to draw firm conclusions from the collected results. Besides an expected difference in outcome between the autograft transfer procedure and the more extensive procedures of mosaicplasty and the use of an allograft, neither a clear nor a significant difference between treatment options could be demonstrated. The need for sufficiently powered prospective investigations in a randomized comparative clinical setting remains high. This present systematic review can be used in order to inform patients about expected outcome of the different treatment methods used after failed primary surgery.Level of evidenceIV.

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“…In such cases, fresh cadaver allograft, with viable chondrocytes and normal subchondral bone, appears as an interesting option, especially because it does not present morbidity in the donor area or areas without coverage between the grafted plugs 47 (Fig. 6).…”

Section: Prognostic Factorsmentioning

confidence: 99%