Outcomes Following Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus at 10-Year Follow-Up: A Retrospective Review.

IF 2.7 4区医学 Q1 ORTHOPEDICS

CARTILAGE Pub Date : 2024-10-29 DOI:10.1177/19476035241293268

James J Butler, Guillaume Robert, Jari Dahmen, Charles C Lin, Joseph X Robin, Alan P Samsonov, Gino M M J Kerkhoffs, John G Kennedy

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引用次数: 0

Abstract

Objective: The purpose of this study was to evaluate outcomes following autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesions of the talus (OLT) at a minimum of 10-year follow-up.

Design: Retrospective chart review identified patients who underwent AOT for the treatment of OLT. Pre-operative magnetic resonance imaging (MRI) scans were obtained in all patients. Clinical outcomes assessed included: pre- and post-operative foot and ankle outcome score (FAOS), visual analog scale (VAS), patient satisfaction, complications, failures and secondary surgical procedures.

Results: Thirty-nine patients with a mean lesion size was 122.3 ± 64.1 mm² and mean follow-up time of 138.9 ± 16.9 months were included. The mean FAOS scores improved from a preoperative score of 51.9 ± 16.0 to 75.3 ± 21.9 (P < 0.001). Increasing lesion size was variable associated with inferior FAOS scores (R² = 0.2228). There was statistically significant higher mean T2 relaxation values at the superficial layer at the site of the AOT graft (42.9 ± 5.2 ms) compared to the superficial layer of the adjacent native cartilage (35.8 ± 3.8 ms) (P < 0.001). Seventeen complications (43.6%) were observed, the most common of which was anterior ankle impingement (25.6%). There were 2 failures (5.1%), both of which had a history of prior bone marrow stimulation via microfracture and post-operative cysts identified on MRI.

Conclusion: This retrospective review found that AOT for the treatment of large OLTs produced a 94.9% survival rate at a minimum of 10-year follow-up. Increasing lesion size was associated with inferior clinical outcomes. The findings of this study indicates that AOT is a viable long-term surgical strategy for the treatment of large OLTs.

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自体骨软骨移植治疗距骨骨软骨损伤后 10 年随访结果：回顾性综述。

研究目的本研究旨在评估自体骨软骨移植（AOT）治疗距骨骨软骨损伤（OLT）后至少10年的随访结果：设计：回顾性病历审查确定了接受AOT治疗OLT的患者。对所有患者进行术前磁共振成像（MRI）扫描。临床结果评估包括：术前和术后足踝结果评分（FAOS）、视觉模拟量表（VAS）、患者满意度、并发症、失败和二次手术：39例患者的平均病变大小为122.3 ± 64.1 mm2，平均随访时间为138.9 ± 16.9个月。平均 FAOS 评分从术前的 51.9 ± 16.0 分提高到 75.3 ± 21.9 分（P < 0.001）。病灶大小的增加与 FAOS 评分的降低有变量关系（R2 = 0.2228）。与邻近的原生软骨浅层（35.8 ± 3.8 ms）相比，AOT 移植部位浅层的平均 T2 松弛值（42.9 ± 5.2 ms）明显更高（P < 0.001）。共观察到 17 例并发症（43.6%），其中最常见的是前踝关节撞击（25.6%）。有 2 例失败（5.1%），这 2 例患者都曾通过微骨折进行骨髓刺激，并在核磁共振成像中发现术后囊肿：这项回顾性研究发现，采用AOT治疗大面积OLT，在至少10年的随访中可获得94.9%的存活率。病灶大小的增加与较差的临床结果有关。这项研究结果表明，AOT是治疗大面积OLT的一种可行的长期手术策略。

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来源期刊

CARTILAGE ORTHOPEDICS-

CiteScore

6.90

自引率

7.10%

发文量

期刊介绍： CARTILAGE publishes articles related to the musculoskeletal system with particular attention to cartilage repair, development, function, degeneration, transplantation, and rehabilitation. The journal is a forum for the exchange of ideas for the many types of researchers and clinicians involved in cartilage biology and repair. A primary objective of CARTILAGE is to foster the cross-fertilization of the findings between clinical and basic sciences throughout the various disciplines involved in cartilage repair. The journal publishes full length original manuscripts on all types of cartilage including articular, nasal, auricular, tracheal/bronchial, and intervertebral disc fibrocartilage. Manuscripts on clinical and laboratory research are welcome. Review articles, editorials, and letters are also encouraged. The ICRS envisages CARTILAGE as a forum for the exchange of knowledge among clinicians, scientists, patients, and researchers. The International Cartilage Repair Society (ICRS) is dedicated to promotion, encouragement, and distribution of fundamental and applied research of cartilage in order to permit a better knowledge of function and dysfunction of articular cartilage and its repair.