Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for lateral osteochondral lesions of the talus: operative technique

Dahmen, Jari; Rikken, Quinten G.H.; Kerkhoffs, Gino M. M. J.; Stufkens, Sjoerd A.S.

doi:10.1007/s00064-022-00789-0

Cited by 4 publications

(1 citation statement)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study has limitations. It was limited to a single treatment arm, and only medial osteochondral lesions of the talus were included even though central and lateral TOPIC procedures are also performed at our institution 50 . Another limitation is the low statistical power concerning the subgroup analyses and potentially correlated factors.…”

Section: Discussionmentioning

confidence: 99%

Talar OsteoPeriostic Grafting from the Iliac Crest (TOPIC)

Dahmen

Rikken

Stufkens

et al. 2023

Journal of Bone and Joint Surgery

Self Cite

View full text Add to dashboard Cite

Background: Press-fit Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) is a novel technique for the treatment of large osteochondral lesions of the talus. The purpose of the present study was to prospectively evaluate the 2-year clinical outcomes for patients with medial osteochondral lesions of the talus that were treated with the TOPIC procedure.Methods: Forty-three patients were prospectively assessed before and 24 months after the TOPIC procedure. All procedures were performed through a medial distal tibial osteotomy. Clinical assessment preoperatively and at 24 months of follow-up included determination of the Numeric Rating Scale (NRS) scores for pain during walking (primary outcome), at rest, during running, and during stair-climbing. The Foot and Ankle Outcome Score (FAOS) and the Mental Component Summary (MCS) score and Physical Component Summary (PCS) score of the Short Form-36 (SF-36) were also assessed. A computed tomography (CT) scan was performed 12 weeks postoperatively to assess union of the distal tibial osteotomy site and at 1 and 2 years postoperatively to assess consolidation of the graft as well as cyst development in the graft.Results: All enrolled patients were available for follow-up. The median NRS score for pain during walking improved from 7 points preoperatively to 2 points at 2 years postoperatively (p < 0.001). All other NRS scores for pain improved significantly. All FAOS subscale scores improved significantly, including those for pain (from 53 to 75), symptoms (from 50 to 61), activities of daily living (from 68 to 88), sports (from 30 to 55), and quality of life (from 19 to 38). The SF-36 PCS score improved from 43 to 48 (p < 0.001), and the MCS score changed from 28 to 26 (p > 0.05). There was a 100% rate of union of the osteotomy site at the distal tibia and 100% of the grafts showed consolidation at 1 and 2 years postoperatively. Conclusions:The TOPIC procedure for large osteochondral lesions of the medial talar dome is an effective technique that resulted in significant improvement exceeding the minimal clinically important difference in pain scores (primary outcome) as well as in other outcomes, with 100% consolidation of the grafts.

show abstract

Section: Discussionmentioning

confidence: 99%

Talar OsteoPeriostic Grafting from the Iliac Crest (TOPIC)

Dahmen

Rikken

Stufkens

et al. 2023

Journal of Bone and Joint Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Sex‐specific analysis in patients undergoing Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large osteochondral lesions of the talus

Dahmen,

Gianakos,

Hollander

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeThe purpose of the present study is to assess the gender‐specific differences in the presentation and outcomes following Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) between male and female patients.MethodsA prospective comparative analysis was performed comparing consecutive female and male patients having been treated by the press‐fit TOPIC procedure. Clinical comparative assessment preoperatively and at 12 months of follow‐up included determination of the Numeric Rating Scale (NRS) scores for pain during walking (primary outcome), at rest and during stair‐climbing. The Foot and Ankle Outcome Score (FAOS) was also assessed. A computed tomography (CT) scan was performed for lesion size, morphology and localization determination preoperatively as well as 10–12 weeks postoperatively to assess the union of the osteotomy site and at 1 year postoperatively to assess consolidation of the graft as well as intra‐graft cyst development.ResultsA total of 48 patients (30 women, 18 men) were eligible for inclusion. Both men and women demonstrated significant functional improvements postoperatively concerning the clinical outcomes with no significant differences between men and women (n.s.) except for a significantly greater improvement in postoperative FAOS pain scores in women. Men presented with OLTs significantly larger in both surface area (208 mm2 for males versus 155 mm2 for females, p < 0.05) as well as lesion volume (3.0 cm3 for males versus 1.8 cm3 for females, p < 0.05). At 1‐year postoperatively, all patients showed graft consolidation. Cyst formation was present in 11 females (37% of the group) and 10 males (59% of the group), respectively (n.s.).ConclusionBoth males and females showed clinically relevant improvements in the clinical outcomes after undergoing the TOPIC procedure with significant differences in preoperative lesion size. The TOPIC procedure is a good treatment strategy for large OLTs in both men and women.Level of EvidenceLevel III, comparative prospective clinical cohort.

show abstract

A matching and localization study of iliac bone graft for repair of talar cartilage injury secondary to lateral ankle instability

Zhao,

Zhang,

2024

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Background: To investigate the search for an Iliac-Talar Grafts on the iliac bone that is morphologically matched to a multiplanar injury lesion of the talus; while utilizing a bone-harvesting guide to ensure precise positioning of the Iliac-Talar Grafts. Methods: A total of twenty-two cases with both talar CT data and iliac CT data were collected from January 2019 to June 2023. One case each of talar deformity injury and bone disease were excluded, resulting in a selection of 20 cases. The medial and lateral target repair areas of the talus were formulated, and virtual surgery was performed by using digital orthopedic technology to locate an iliac-talar restoration on the iliac bone that matched the morphology of the multiplanar injury lesion of the talus. 3D chromatographic deviation analysis was used to assess the accuracy of Iliac-Talar Grafts in terms of morphometric matching and positioning, while personalized iliac bone extraction guides were designed to ensure accurate positioning of the Iliac-Talar Grafts. Results: The best fitting point for repairing the medial talar lesion is determined to be medial to the anterior iliac crest, specifically 2.935 ± 0.365 cm posterior to the anterior superior iliac spine, and 2.550 ± 0.559 cm anterior to the valgus-iliac crest point (VICP). Similarly, for the repair of the lateral talar lesion, the ideal position is found to be lateral to the posterior iliac crest, approximately 2.695 ± 0.640 cm posterior to the valgus-iliac crest point (VICP). Utilizing bone extraction guides enables precise positioning for iliac bone extraction. Conclusion: This study utilizes virtual surgery, 3D chromatographic deviation analysis, and guide plate techniques in digital orthopedics to precisely locate the Iliac-Talar Graft on the iliac bone, matching the morphology of the talar lesion; it provides a new solution for cutting the iliac bone implant that matches the the multifaceted talar lesion to be repaired.

show abstract

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for lateral osteochondral lesions of the talus: operative technique

Cited by 4 publications

References 46 publications

Talar OsteoPeriostic Grafting from the Iliac Crest (TOPIC)

Talar OsteoPeriostic Grafting from the Iliac Crest (TOPIC)

Sex‐specific analysis in patients undergoing Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large osteochondral lesions of the talus

A matching and localization study of iliac bone graft for repair of talar cartilage injury secondary to lateral ankle instability

Contact Info

Product

Resources

About