Long-term results of osteochondral autograft transplantation of the talus with a novel groove malleolar osteotomy technique

• Published in: Joint diseases and related surgery Vol. 31; no. 3; pp. 509 - 515
• Main Authors: Toker, Berkin, Erden, Tunay, Çetinkaya, Sarper, Dikmen, Göksel, Özden, Vahit Emre, Taşer, Ömer
• Format: Journal Article
• Language: English
• Published: Turkey Bayçınar Medical Publishing 01.01.2020
• Subjects: Adult; Ankle Joint - physiopathology; Ankle Joint - surgery; Autografts; Bone Transplantation - adverse effects; Bone Transplantation - instrumentation; Bone Transplantation - methods; Female; Follow-Up Studies; Humans; Male; Original; Osteotomy - adverse effects; Osteotomy - methods; Postoperative Complications - diagnosis; Postoperative Complications - surgery; Range of Motion, Articular; Reoperation - methods; Retrospective Studies; Talus - pathology; Talus - surgery; Treatment Outcome; Visual Analog Scale
• ISSN: 2687-4784; 2687-4792
• DOI: 10.5606/ehc.2020.75231

This study aims to evaluate the long-term results of osteochondral autograft transfer (OAT) of talar lesions performed using a modified osteotomy technique. This retrospective study included 20 consecutive patients (11 males, 9 females; mean age 33.5±11 years; range, 15 to 56 years) (21 ankles) with osteochondral lesions of the talus (OLT) treated with the OAT system between August 2002 and October 2008. We performed a modified sulcus groove osteotomy, which provides better exposure of medial and central lesions. After a minimum duration of 10 years following surgery, patients' clinical functions were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle- hindfoot scale and visual analog scale (VAS). The Tegner-Lysholm scoring system was used to determine the levels of knee activity. The mean follow-up period was 143.5 (range, 120 to 186) months. The mean AOFAS scores significantly improved from 60.4±7.4 (range, 48 to 70) preoperatively to 86.2±9.2 (range, 60 to 94) at the last follow-up (p≤0.05). The mean ankle VAS score significantly decreased from 6.3±0.4 (range, 5 to 7) preoperatively to 2.0±1.4 (range, 0 to 4). The mean Tegner-Lysholm score for this group was 89.7±11.7 (range, 68 to 100). Revision surgery was performed in only two patients because of impingement and arthritis. Recurrent knee pain at the donor site of the osteochondral autograft was observed in three (14%) patients. In the present study, good to excellent results were obtained in the treatment of OLT with OAT for a minimum follow-up duration of 10 years. This novel technique can also simplify the steep learning curve, which is challenging for surgeons.