Yoshiharu Shimozono1,2,3, Eoghan T Hurley1,4, Charles L Myerson1,5, John G Kennedy6. 1. Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA. 2. Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan. 3. Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. 4. Royal College of Surgeons in Ireland, Dublin, Ireland. 5. Tulane University School of Medicine, New Orleans, LA, USA. 6. Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA. KennedyJ@hss.edu.
Abstract
PURPOSE: Autologous osteochondral transplantation is an established treatment for large-sized osteochondral lesions of the talus (OLT) with excellent short term outcomes. However, few studies assess the outcomes of autologous osteochondral transplantation at mid-term follow-up. The purpose of the current systematic review was to evaluate the clinical outcomes of the autologous osteochondral transplantation procedure in the treatment of OLT at mid-term and long-term follow-up. METHODS: A systematic search of the MEDLINE, EMBASE and Cochrane Library databases was performed in October 2017 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were evaluated with regard to level of evidence (LOE) and quality of evidence (QOE) using the Coleman Methodology Score. Clinical outcomes, and complications were also evaluated. RESULTS: Eleven studies, with 500 ankles were included at a mean 62.8 months follow-up. Seven studies used the American Orthopaedic Foot and Ankle Society (AOFAS) score. The weighted mean preoperative AOFAS score was 55.1 ± 6.1, and the postoperative score was 86.2 ± 4.5, with 87.4% of patients (132 of 151) being reported as excellent or good results. In total, 53 of the 500 patients (10.6%) had complications. The most common complication was donor site morbidity with 18 patients (3.6%) at final follow-up. Thirty-one patients (6.2%) underwent reoperations, and 5 ankles (1.0%) were regarded as failed autologous osteochondral transplantation. CONCLUSION: The current systematic review demonstrated that good clinical and functional outcomes can be expected following autologous osteochondral transplantation for the treatment of OLT, with a low failure rate. The results from this study show patients can be reasonably counselled to expect good clinical outcomes in the mid-term. MRI and radiographs showed restoration of articular surface as well as a minimal presence of osteoarthritis at mid-term follow-up. However, as low level and quality of evidence and the variability of the data may confound the data, further well-designed studies are necessary to determine the effectiveness of autologous osteochondral transplantation in the treatment for OLT. LEVEL OF EVIDENCE: IV.
PURPOSE: Autologous osteochondral transplantation is an established treatment for large-sized osteochondral lesions of the talus (OLT) with excellent short term outcomes. However, few studies assess the outcomes of autologous osteochondral transplantation at mid-term follow-up. The purpose of the current systematic review was to evaluate the clinical outcomes of the autologous osteochondral transplantation procedure in the treatment of OLT at mid-term and long-term follow-up. METHODS: A systematic search of the MEDLINE, EMBASE and Cochrane Library databases was performed in October 2017 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were evaluated with regard to level of evidence (LOE) and quality of evidence (QOE) using the Coleman Methodology Score. Clinical outcomes, and complications were also evaluated. RESULTS: Eleven studies, with 500 ankles were included at a mean 62.8 months follow-up. Seven studies used the American Orthopaedic Foot and Ankle Society (AOFAS) score. The weighted mean preoperative AOFAS score was 55.1 ± 6.1, and the postoperative score was 86.2 ± 4.5, with 87.4% of patients (132 of 151) being reported as excellent or good results. In total, 53 of the 500 patients (10.6%) had complications. The most common complication was donor site morbidity with 18 patients (3.6%) at final follow-up. Thirty-one patients (6.2%) underwent reoperations, and 5 ankles (1.0%) were regarded as failed autologous osteochondral transplantation. CONCLUSION: The current systematic review demonstrated that good clinical and functional outcomes can be expected following autologous osteochondral transplantation for the treatment of OLT, with a low failure rate. The results from this study show patients can be reasonably counselled to expect good clinical outcomes in the mid-term. MRI and radiographs showed restoration of articular surface as well as a minimal presence of osteoarthritis at mid-term follow-up. However, as low level and quality of evidence and the variability of the data may confound the data, further well-designed studies are necessary to determine the effectiveness of autologous osteochondral transplantation in the treatment for OLT. LEVEL OF EVIDENCE: IV.
Authors: Peter Cornelius Kreuz; Matthias Steinwachs; Christoph Erggelet; Andreas Lahm; Philipp Henle; Philipp Niemeyer Journal: Am J Sports Med Date: 2005-09-12 Impact factor: 6.202
Authors: Yoshiharu Shimozono; Max Coale; Youichi Yasui; Amanda O'Halloran; Timothy W Deyer; John G Kennedy Journal: Am J Sports Med Date: 2017-11-16 Impact factor: 6.202
Authors: John V Marymont; Gerald Shute; Hongseng Zhu; Kevin E Varner; Vibor Paravic; John L Haddad; Philip C Noble Journal: Foot Ankle Int Date: 2005-09 Impact factor: 2.827
Authors: John M Pinski; Lorraine A Boakye; Christopher D Murawski; Charles P Hannon; Keir A Ross; John G Kennedy Journal: Arthroscopy Date: 2015-09-11 Impact factor: 4.772
Authors: Ethan J Fraser; Mark C Harris; Marcelo P Prado; John G Kennedy Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-05-12 Impact factor: 4.342
Authors: Ian Savage-Elliott; Niall A Smyth; Timothy W Deyer; Christopher D Murawski; Keir A Ross; Charles P Hannon; Huong T Do; John G Kennedy Journal: Arthroscopy Date: 2016-07-22 Impact factor: 4.772
Authors: Andrew W Ross; Christopher D Murawski; Ethan J Fraser; Keir A Ross; Huong T Do; Timothy W Deyer; John G Kennedy Journal: Arthroscopy Date: 2016-04-06 Impact factor: 4.772
Authors: James Toale; Yoshiharu Shimozono; Conor Mulvin; Jari Dahmen; Gino M M J Kerkhoffs; John G Kennedy Journal: Orthop J Sports Med Date: 2019-10-30