title: Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions of the talus.
abstract: The treatment of osteochondral lesions of the talus has evolved with the development of improved imaging and arthroscopic techniques. However, the outcome of treatment for large cystic type-V lesions is poor, using conventional grafting, debridement or microfracture techniques. This retrospective study examined the outcomes of 50 patients with a cystic talar defect who were treated with arthroscopically harvested, cored osteochondral graft taken from the ipsilateral knee. Of the 50 patients, 45 (90%) had a mean good to excellent score of 80.3 (52 to 90) in the Karlsson-Peterson Ankle Score, at a mean follow-up of 36 months (24 to 83). A malleolar osteotomy for exposure was needed in 26 patients and there were no malleolar mal- or nonunions. One patient had symptoms at the donor site three months after surgery; these resolved after arthroscopic release of scar tissue. This technique is demanding with or without a malleolar osteotomy, but if properly performed has a high likelihood of success.
authors.affiliation: University of Washington, Seattle, WA, USA. piercescranton@hotmail.com
authors.forename: P E
authors.initials: PE
authors.lastname: Scranton
authors.forename: C C
authors.initials: CC
authors.lastname: Frey
authors.forename: K S
authors.initials: KS
authors.lastname: Feder
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000150:complications / Q000503:physiopathology; D001182:Arthroscopy / Q000379:methods; D001845:Bone Cysts / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D013628:Talus / Q000601:surgery*; D016896:Treatment Outcome