Results of Autologous Osteochondral Transplantation of the Ostochondral Lesion on the Talus: A Comparison Study between Medial Malleolar Osteotomy Approach and Anterior Arthrotomy Approach.
10.14193/jkfas.2017.21.4.139
- Author:
Yong Sik LEE
1
;
Gil Yeong AHN
;
Il Hyun NAM
;
Yeong Hyun LEE
;
Tae Hun LEE
;
Dae Geun KIM
;
Dong Hyun LEE
Author Information
1. Department of Orthopedic Surgery, Pohang St. Mary's Hospital, Pohang, Korea. osbonelee@gmail.com
- Publication Type:Original Article
- Keywords:
Talus;
Osteochondral lesion;
Autologous osteochondral graft;
Medial malleolar osteotomy
- MeSH:
Ankle;
Bone Cysts;
Follow-Up Studies;
Foot;
Humans;
Methods;
Osteotomy*;
Talus*;
Transplants
- From:Journal of Korean Foot and Ankle Society
2017;21(4):139-143
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. MATERIALS AND METHODS: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. RESULTS: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. CONCLUSION: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).
