Early results of autologous chondrocyte implantation in the talus

• Published in: Journal of bone and joint surgery. British volume Vol. 87; no. 2; pp. 179 - 183
• Main Authors: WHITTAKER, J.-P, SMITH, G, MAKWANA, N, ROBERTS, S, HARRISON, P. E, LAING, P, RICHARDSOR, J. B
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.02.2005; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Adolescent; Adult; Ankle Injuries - surgery; Ankle Joint - physiopathology; Arthroscopy - methods; Biological and medical sciences; Cartilage, Articular - physiopathology; Cartilage, Articular - surgery; Chondrocytes - transplantation; Diseases of the osteoarticular system; Female; Humans; Knee Joint - physiopathology; Knee Joint - surgery; Male; Medical sciences; Middle Aged; Orthopedic surgery; Patient Satisfaction; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Talus - surgery; Treatment Outcome; Knee; Prognosis; Chondrocyte; Satisfaction; Review; Epidemiology; Cartilage; Ankle joint; Arthroscopy; Endoscopy; Human; Evaluation scale; Donor site; Heel; Implantation; Autologous system; Astragalus; Morbidity; Foot; Ankle; Orthopedic surgery; Treatment; Early; Lesion; Bibliographic review
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620x.87b2.15376

Autologous chondrocyte implantation (ACI) has been used most commonly as a treatment for cartilage defects in the knee and there are few studies of its use in other joints. We describe ten patients with an osteochondral lesion of the talus who underwent ACI using cartilage taken from the knee and were prospectively reviewed with a mean follow-up of 23 months. In nine patients the satisfaction score was 'pleased' or 'extremely pleased', which was sustained at four years. The mean Mazur ankle score increased by 23 points at a mean follow-up of 23 months. The Lysholm knee score returned to the pre-operative level at one year in three patients, with the remaining seven showing a reduction of 15% at 12 months, suggesting donor-site morbidity. Nine patients underwent arthroscopic examination at one year and all were shown to have filled defects and stable cartilage. Biopsies taken from graft sites showed mostly fibrocartilage with some hyaline cartilage. The short-term results of ACI for osteochondral lesions of the talus are good despite some morbidity at the donor site.