title: Bony periosteum-covered iliac crest plug transplantation for severe osteochondral lesions of the talus: a modified mosaicplasty procedure.
abstract: OBJECTIVE
  This study reports first evidence of a modified procedure for osteochondral autologous transplantation where bony periosteum-covered plugs are harvested at the iliac crest and transplanted into the talar osteochondral lesion.
  
  
  METHODS
  Thirteen out of 14 patients, average age 39.6 (SD 14.4) years, were followed clinically and radiographically for a median of 25 (24-28) months (minimal follow-up, 24 months).
  
  
  RESULTS
  For these 13 patients, the American Orthopaedic Foot and Ankle Society hindfoot score increased from 47 (SD 11) points pre-operatively, to 81 (SD 14) points postoperatively (p < 0.0001). The average pain score decreased from 6.6 (SD 1.3) points pre-operatively, to 1.4 (SD 1.9) points postoperatively (p < 0.0001). Seven patients returned to sports activity. Radiographically good plug osteointegration was observed in nine out of 11 ankles. Follow-up arthroscopy showed fibrous cartilage in four ankles, periosteum hypertrophy in five ankles, and partial or total missing of coverage of the bone in three ankles. Three revision surgeries had to be performed.
  
  
  CONCLUSIONS
  This modified mosaicplasty might be recommended for severe and recurrent osteochondral lesions of the talus and may lead to restoration of the subchondral bone stock, formation of fibro-cartilage, and stable joint function.
  
  
  METHODS
  IV.
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Spitalstr. 21, 4031, Basel, Switzerland, aleumann@uhbs.ch.
authors.forename: André
authors.initials: A
authors.lastname: Leumann
authors.forename: Victor
authors.initials: V
authors.lastname: Valderrabano
authors.forename: Martin
authors.initials: M
authors.lastname: Wiewiorski
authors.forename: Alexej
authors.initials: A
authors.lastname: Barg
authors.forename: Beat
authors.initials: B
authors.lastname: Hintermann
authors.forename: Geert
authors.initials: G
authors.lastname: Pagenstert
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000601:surgery*; D001182:Arthroscopy; D001847:Bone Diseases / Q000601:surgery*; D016025:Bone Transplantation; D002356:Cartilage / Q000637:transplantation; D002357:Cartilage Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D010521:Periosteum / Q000637:transplantation; D011446:Prospective Studies; D013628:Talus / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous