No mid-term difference in mosaicplasty in previously treated versus previously untreated patients with osteochondral lesions of the talus.
BACKGROUND
Osteochondral transplantations, albeit technically challenging, appear promising not only in knee joint lesions, but also in the treatment of talus lesions. We hypothesized that in patients suffering osteochondral lesions of the talus, favorable outcomes are obtained in patients undergoing primary mosaicplasty as compared to patients undergoing secondary mosaicplasty.


METHODS
Over a 3-year period (1998-2001), 14 patients (six male, eight female, median age 22 years) were treated with an autologous osteochondral transplantation of the talus. Eight patients were previously untreated (group I). Six patients had previous ankle procedures, such as microfracturing (group II). The median follow-up was 24 months and 100% complete at 12 months. The functional outcome was evaluated at least at 6 weeks, 12 weeks, and 1 year after surgery using pain on a visual analog scale (VAS) and sports activity was recorded at 1 year after surgery. In ten patients, magnetic resonance imaging (MRI) of the ankle was performed at 1 year after surgery (group I/II: 7/3).


RESULTS
Overall ankle pain was decreased from 6.9 +/- 2.1 to 4.0 +/- 2.8 postoperatively. The mean knee pain for the donor knee was 2.6 +/- 2.4. We found no significant difference between the primary mosaicplasty group and the secondary mosaicplasty group with regard to pain. MRI scans of ten patients showed a complete incorporation of the osteochondral cylinders at 1 year after surgery.


CONCLUSIONS
Favorable outcomes were obtained in patients undergoing primary mosaicplasty as compared to patients undergoing secondary mosaicplasty. We found no significant difference among patients with previous ankle surgery in contrast to those without, with a median 24-months follow-up.
Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany. haasper.carl@mh-hannover.de
Carl
C
Haasper
Boris A
BA
Zelle
Karsten
K
Knobloch
Michael
M
Jagodzinski
Musa
M
Citak
Joachim
J
Lotz
Christian
C
Krettek
Johannes
J
Zeichen
D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001847:Bone Diseases / Q000601:surgery; D016025:Bone Transplantation; D002358:Cartilage, Articular / Q000637:transplantation*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010008:Osteochondritis Dissecans / Q000175:diagnosis / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D013628:Talus / Q000293:injuries / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome