Background: Fresh osteochondral allograft (OCA) transplantation represents a biologic restoration technique as an
alternative treatment option for larger osteochondral lesions of the talus (OLT). The purpose of this study was to evaluate
midterm outcomes after OCA transplantation for the treatment of OLT.
Methods: Nineteen patients (20 ankles) received partial unipolar OCA transplant for symptomatic OLT between January
1998 and October 2014. The mean age was 34.7 years, and 53% were male. The average graft size was 3.8 cm2. All patients
had a minimum follow-up of 2 years. Outcomes included the American Academy of Orthopaedic Surgeons Foot and Ankle
Module (AAOS-FAM), the Olerud-Molander Ankle Score (OMAS), and pain and satisfaction questionnaires. Failure of
OCA was defined as conversion to arthrodesis or revision OCA transplantation.
Results: Five of 20 ankles (25%) required further surgery, of which 3 (5%) were considered OCA failures (2 arthrodesis and
1 OCA revision). The mean time to failure was 3.5 (range, 0.9 to 6.7) years. Survivorship was 88.7% at 5 years and 81.3% at
10 years. The median follow-up of the 17 patients with grafts in situ was 9.7 years. The mean OMAS improved significantly
from 40 points preoperatively to 71 points postoperatively (P < .05; range, 5 to 55). The mean postoperative AAOS-FAM
core score was 81.5 ± 15 (range, 40.5 to 96.6). Fifteen of 17 patients responded to follow-up questions regarding their ankle;
14 patients reported less pain and better function, and 13 patients were satisfied with the results of the procedure.
Conclusion: Our study of midterm results after OCA transplantations showed that this procedure was a reasonable
treatment option for large OLT.
Level of Evidence: Level IV, case series.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:82884 |
| Date | 11 January 2023 |
| Creators | Gaul, Florian, Tírico, Luis E.P., McCauley, Julie C., Pulido, Pamela A., Bugbee, William D. |
| Publisher | Sage |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 10.1177/1071100718805064 |
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