Factors Associated With the Clinical Outcomes of the Osteochondral Autograft Transfer System in Osteochondral Lesions of the Talus

Abstract

This study showed that the articular surface of the tibial plafond at the malleolar osteotomy site, soft tissue impingement, and uncovered areas around the graft were important factors affecting the clinical outcomes, as observed through second-look arthroscopy. Therefore, surgeons should restore the articular surface accurately after the osteotomy, and more caution should be taken to avoid soft tissue impingement and uncovered areas around the graft when performing osteochondral autograft transfer.

Autologous osteochondral transplantation for osteochondral lesions of the talus in an athletic population

“…Kim et al [27] assessed predictors of outcomes in talar AOT procedures, finding that post-operative soft tissue impingement, uncovered lesion areas and arthroscopic findings such as cartilage surface incongruence resulted in significantly poorer outcomes. Conversely, they found no correlation with age, BMI, lesion size or lesion location and outcomes.…”

Midterm clinical results of osteochondral autograft transplantation for advanced stage Freiberg disease

“…OAT is one of the established procedures for limited size osteochondral lesions in the knee, ankle and elbow joints. Application of this technique for hip lesions has recently been reported [14][15][16][17][18][19][20][21].…”

A Firm Foundation

“…16,18,20 Osteotomy may be needed to access some lesions properly, but it has been associated with lower outcome scores. 17,19 In the case of autografts, it has been hypothesized that structural differences between the host and donor sites may potentially affect the outcome. 7 In another original article in this month's AJSM, Giannini and colleagues 10 report the results of yet another method of repairing OLT that is applicable to larger lesions.…”

“…As with many conditions that we treat, short-term results may appear favorable despite the failure to re-establish normal anatomy, but it seems likely that restoration of hyaline cartilage will prove more durable in the long run. Advanced MRI techniques seem to have the greatest potential for documenting the nature of the reconstituted articular surface, as direct arthroscopic evaluation 17,22 is often impractical, and plain radiographs, computed tomography, 8 and even conventional MRI 8,16 are limited in their abilities. 8,16 If the foot is the indispensable foundation of the body, the talus is both the capstone of that foundation and the cornerstone for the human temple that it supports.…”