Boguslaw Sadlik1, Lukasz Kolodziej2, Adrian Blasiak3, Mateusz Szymczak4, Bartłomiej Warchal5. 1. Biologic Joint Reconstruction Department, St Luke's Hospital, Bielsko-Biala, Poland. Electronic address: sadlik@lukasza.pl. 2. Orthopaedic, Traumatology and Orthopaedic Oncology Clinic, Pomeranian Medical University, Unii Lubelskiej 1 Str., 71-252 Szczecin, Poland. Electronic address: lukas@hot.pl. 3. Biologic Joint Reconstruction Department, St Luke's Hospital, Bielsko-Biala, Poland. Electronic address: blasiak@lukasza.pl. 4. Orthopaedic Department, Nicolaus Copernicus Hospital, Torun, Poland. Electronic address: mat-sz@wp.pl. 5. Biologic Joint Reconstruction Department, St Luke's Hospital, Bielsko-Biala, Poland. Electronic address: warchal@lukasz.pl.
Abstract
BACKGROUND: Surgical treatment for large osteochondral lesions of the talar dome (OLTD) must restore the convexity and curvature of the talus. Here, we present midterm results and describe the modified "sandwich" reconstruction procedure. Bone defects were restored using a biological inlay consists of autologous bone chips that were mixed with bone marrow concentrate and fibrin glue and covered with a xenogeneic collagen membrane infiltrated with bone marrow concentrate and stabilized by fibrin glue. METHODS: Ten patients who were treated using a modified "sandwich" OLTD reconstruction were assessed after an average follow-up period of 46.4 (±18) months, using the clinical American Orthopaedic Foot and Ankle Society Ankle Hindfoot Scale (AOFAS) score and radiological magnetic resonance observation of cartilage repair tissue (MOCART) score. RESULTS: The mean AOFAS score increased significantly from 58.3 (±8.5) points to 81.8 (±15.5) points as well the mean VAS score reduced significantly from 5.58 (±0.97) to 1.83 (±0.93) points. The average MOCART score was 69.5% (±16.7%) in the final follow-up. CONCLUSIONS: The presented modified "sandwich" technique permanently recreates the convexity and curvature in large osteochondral lesions of the talar dome with a single step surgical procedure.
BACKGROUND: Surgical treatment for large osteochondral lesions of the talar dome (OLTD) must restore the convexity and curvature of the talus. Here, we present midterm results and describe the modified "sandwich" reconstruction procedure. Bone defects were restored using a biological inlay consists of autologous bone chips that were mixed with bone marrow concentrate and fibrin glue and covered with a xenogeneic collagen membrane infiltrated with bone marrow concentrate and stabilized by fibrin glue. METHODS: Ten patients who were treated using a modified "sandwich" OLTD reconstruction were assessed after an average follow-up period of 46.4 (±18) months, using the clinical American Orthopaedic Foot and Ankle Society Ankle Hindfoot Scale (AOFAS) score and radiological magnetic resonance observation of cartilage repair tissue (MOCART) score. RESULTS: The mean AOFAS score increased significantly from 58.3 (±8.5) points to 81.8 (±15.5) points as well the mean VAS score reduced significantly from 5.58 (±0.97) to 1.83 (±0.93) points. The average MOCART score was 69.5% (±16.7%) in the final follow-up. CONCLUSIONS: The presented modified "sandwich" technique permanently recreates the convexity and curvature in large osteochondral lesions of the talar dome with a single step surgical procedure.
Authors: Chengchong Ai; Yee Han Dave Lee; Xuan Hao Tan; Si Heng Sharon Tan; James Hoi Po Hui; James Cho-Hong Goh Journal: J Orthop Translat Date: 2021-10-11 Impact factor: 5.191
Authors: Filippo Migliorini; Nicola Maffulli; Alice Baroncini; Jörg Eschweiler; Matthias Knobe; Markus Tingart; Hanno Schenker Journal: Am J Sports Med Date: 2021-09-23 Impact factor: 7.010