Results and Functional Outcomes of Structural Fresh Osteochondral Allograft Transfer for Treatment of Osteochondral Lesions of the Talus in a Highly Active Population

Orr, Justin D.; Dunn, John C.; Heida, Kenneth A.; Kusnezov, Nicholas; Waterman, Brian R.; Belmont, Philip J.

doi:10.1177/1938640016666924

Cited by 28 publications

(34 citation statements)

References 22 publications

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“…The range of the success percentages per study for the treatment strategy group of osteo(chondral) transplantation was 20 to 100% [CI 4–100%] (Fig. 3) [2, 3, 7, 22, 29, 36, 40, 47, 53, 54, 57, 62–64, 92, 105, 132, 136]. The range of the means of the success percentage per separate publication for the OATS group was 40–100% [CI 12–100%] (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…3) [22, 53]. Three studies—with in total 19 ankles—investigated the clinical effectiveness of a fresh allograft transplantation, and the success rates ranged from 20 to 100% [CI 4–100%] [7, 36, 92]. Additionally, there were two studies performing implementation of cancellous bone grafting into 29 debrided talar OCDs [62, 105].…”

Section: Resultsmentioning

confidence: 99%

“…It was not possible to extract sufficient information on the symptom duration, patient subjective satisfaction scores and staging of the defect. The range of the means of the follow-up duration was 14–84 months, and the range of the means of the sizes per particular study 1.0 to 2.4 cm 2 [ 3 , 22 , 36 , 40 , 47 , 57 , 64 , 92 ]. The range of the success percentages per study for the treatment strategy group of osteo(chondral) transplantation was 20 to 100% [CI 4–100%] (Fig.…”

Section: Resultsmentioning

confidence: 99%

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No superior treatment for primary osteochondral defects of the talus

Dahmen

Lambers

Reilingh

et al. 2017

Knee Surg Sports Traumatol Arthrosc

145

131

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PurposeThe purpose of this systematic literature review is to detect the most effective treatment option for primary talar osteochondral defects in adults.MethodsA literature search was performed to identify studies published from January 1996 to February 2017 using PubMed (MEDLINE), EMBASE, CDSR, DARE, and CENTRAL. Two authors separately and independently screened the search results and conducted the quality assessment using the Newcastle–Ottawa Scale. Subsequently, success rates per separate study were calculated. Studies methodologically eligible for a simplified pooling method were combined.ResultsFifty-two studies with 1236 primary talar osteochondral defects were included of which forty-one studies were retrospective and eleven prospective. Two randomised controlled trials (RCTs) were identified. Heterogeneity concerning methodological nature was observed, and there was variety in reported success rates. A simplified pooling method performed for eleven retrospective case series including 317 ankles in the bone marrow stimulation group yielded a success rate of 82% [CI 78–86%]. For seven retrospective case series investigating an osteochondral autograft transfer system or an osteoperiosteal cylinder graft insertion with in total 78 included ankles the pooled success rate was calculated to be 77% [CI 66–85%].ConclusionsFor primary talar osteochondral defects, none of the treatment options showed any superiority over others.Level of evidenceIV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

No superior treatment for primary osteochondral defects of the talus

Dahmen

Lambers

Reilingh

et al. 2017

Knee Surg Sports Traumatol Arthrosc

145

131

View full text Add to dashboard Cite

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“…Although the incidence of graft resorption after osteochondral allograft transplantation is relatively high, many studies suggest that graft resorption has no significant negative influence on the clinical outcomes [19–21]. In a study published by Raikin, although the incidence of graft resorption was up to 66.7%, the American Orthopedic Foot and Ankle Society (AOFAS) score significantly improved from 38 preoperatively to 85 postoperatively ( P < .05) [19].…”

Section: Discussionmentioning

confidence: 99%

Osteochondral allograft transplantation for large Hill-Sachs lesions: a retrospective case series with a minimum 2-year follow-up

Zhuo

Zhu

et al. 2019

J Orthop Surg Res

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PurposeTo investigate the clinical outcomes after osteochondral allograft transplantation for large Hill-Sachs lesions.MethodsPatients who underwent osteochondral allograft transplantation for large Hill-Sachs lesions were identified. Clinical assessment consisted of active range of motion (ROM), American Shoulder and Elbow Surgeons score (ASES), Constant-Murley score, Rowe score, and patient satisfaction rate. Radiographic assessment was performed with CT scan.ResultsNineteen patients met the inclusion criteria. The mean age was 21.7 years. The mean preoperative size of the Hill-Sachs lesion was 35.70 ± 3.02%. The mean follow-up was 27.8 months. All grafts achieved union at an average of 3.47 months after surgery. At the final follow-up, graft resorption was observed in 43.1% of patients. The average size of residual humeral head articular arc loss was 12.31 ± 2.79%. Significant improvements (P < .001) were observed for the active ROM, ASES score, Constant-Murley score, and Rowe score. The overall satisfaction rate was 94.7%. No significant difference was found between the resorption group and the nonresorption group in postoperative clinical outcomes.ConclusionOsteochondral allograft transplantation is a useful treatment option for patients with large Hill-Sachs lesions. Although the incidence of graft resorption may be relatively high, the clinical outcomes at a minimum 2-year follow-up are favorable.Level of evidenceLevel IV, case series

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“…If compared with the abundant clinical data of the knee joint, OCA transplantations of the ankle are less frequent and have generally a higher failure rate and therefore often require further surgery. 2,21,25 If a primary ankle allograft fails, options remaining for salvage procedure are limited to arthroplasty, arthrodesis, or revision OCA transplantation. However, the available literature regarding these procedures is extremely rare, when most current publications are focused either on arthrodesis as a salvage procedure after primary failed ankle arthroplasty or after non-union of primary arthrodesis.…”

Section: Introductionmentioning

confidence: 99%