Osteochondral autografts for osteochondritis dissecans of the talus.
Eighteen symptomatic advanced-stage osteochondritis dissecans (OCD) of the talus (Berndt and Harty stages III 7 and IV 11) in 17 patients were treated with multiple autogenous osteochondral cylindrical grafts. The mean time of follow-up was 36 months (range, 25-49). The average age at surgery was 22.7 years (range, 19-34). The mean size of defect of OCD was 13.6 mm x 7.2 mm. Two or three osteochondral grafts (6 or 7 mm in diameter and 15-20 mm in length) were harvested from the superomedial margin of the ipsilateral knee. A partial osteotomy of the medial malleolus or osteotomy of the distal lateral tibia was performed for all cases. Being evaluated by the Freiburg ankle score, 16 of 18 ankles (88.8%) had excellent and two (11.8%) had good results. "Second-look" arthroscopy of 16 ankles revealed consistency of the osteochondral grafts and congruity between grafts and native cartilage in 14 (87.5%), and a softening or fissuring of the osteochondral graft in two. Our results showed that this procedure provided an effective treatment for a symptomatic advanced-stage OCD of the talus.
Lee
Chian-Her
CH
Department of Orthopaedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. chianherlee@yahoo.com.tw
Chao
Kuo-Hua
KH
Huang
Guo-Shu
GS
Wu
Shing-Sheng
SS
D000328:Adult; D000843:Ankle Joint / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods; D002358:Cartilage, Articular / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D010008:Osteochondritis Dissecans / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D024162:Second-Look Surgery; D013628:Talus / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome