Wan Chen1, Kanglai Tang2, Chengsong Yuan1, You Zhou1, Xu Tao1. 1. Department of Orthopaedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. 2. Department of Orthopaedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. Electronic address: tangkanglai@hotmail.com.
Abstract
PURPOSE: To investigate the clinical and radiologic outcomes of an autologous osteoperiosteal cylinder graft from the medial tibia for the treatment of large cystic medial osteochondral lesions (OCLs) of the talus. METHODS: The study included 15 patients with large cystic medial OCLs. All underwent medial malleolus osteotomy and excision and curettage of the defect site, followed by transplantation with an autologous osteoperiosteal cylinder graft from the medial tibia. They were evaluated preoperatively and after a minimum of 24 months (mean, 44.8 months; range, 24 to 72 months) postoperatively by a visual analog scale, the American Orthopaedic Foot & Ankle Society ankle-hindfoot scale, the Ogilvie-Harris scale, and magnetic resonance imaging of the ankle. RESULTS: The mean visual analog scale score decreased from 5.40 ± 1.06 points to 1.00 ± 1.00 points (P < .001), and the mean American Orthopaedic Foot & Ankle Society score increased from 49.00 ± 8.96 points to 89.00 ± 4.17 points (P < .001). The mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was 64.00 ± 5.07 points. According to the Ogilvie-Harris scale, 7 cases were rated as excellent, 5 as good, 3 as fair, and 0 as poor. No complications were observed. CONCLUSIONS: An autologous osteoperiosteal cylinder graft from the medial tibia is effective for treating large cystic medial OCLs of the talus and has a low rate of complications. LEVEL OF EVIDENCE: Level IV, case series.
PURPOSE: To investigate the clinical and radiologic outcomes of an autologous osteoperiosteal cylinder graft from the medial tibia for the treatment of large cystic medial osteochondral lesions (OCLs) of the talus. METHODS: The study included 15 patients with large cystic medial OCLs. All underwent medial malleolus osteotomy and excision and curettage of the defect site, followed by transplantation with an autologous osteoperiosteal cylinder graft from the medial tibia. They were evaluated preoperatively and after a minimum of 24 months (mean, 44.8 months; range, 24 to 72 months) postoperatively by a visual analog scale, the American Orthopaedic Foot & Ankle Society ankle-hindfoot scale, the Ogilvie-Harris scale, and magnetic resonance imaging of the ankle. RESULTS: The mean visual analog scale score decreased from 5.40 ± 1.06 points to 1.00 ± 1.00 points (P < .001), and the mean American Orthopaedic Foot & Ankle Society score increased from 49.00 ± 8.96 points to 89.00 ± 4.17 points (P < .001). The mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was 64.00 ± 5.07 points. According to the Ogilvie-Harris scale, 7 cases were rated as excellent, 5 as good, 3 as fair, and 0 as poor. No complications were observed. CONCLUSIONS: An autologous osteoperiosteal cylinder graft from the medial tibia is effective for treating large cystic medial OCLs of the talus and has a low rate of complications. LEVEL OF EVIDENCE: Level IV, case series.
Authors: Jari Dahmen; Kaj T A Lambers; Mikel L Reilingh; Christiaan J A van Bergen; Sjoerd A S Stufkens; Gino M M J Kerkhoffs Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-27 Impact factor: 4.342