title: Autologous osteochondral transplantation for osteochondral lesions of the talus in an athletic population.
abstract: OBJECTIVE
  To assess clinical outcomes and return to sport in an athletic population treated with autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus.
  
  
  METHODS
  A total of 36 patients were included in this retrospective study including 21 professional athletes and 15 amateur athletes who participated in regular moderate- or high-impact athletic activity. All patients underwent autologous osteochondral transplantation of the talus under the care of a single surgeon. At a mean follow-up of 5.9 years, patients were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system. All patients also received pre-operative MRI with the follow-up MRI performed at 1 year and underwent assessment of return to athletic activity.
  
  
  RESULTS
  The overall AOFAS score improved from 65.5 (SD ± 11.1) to 89.4 (SD ± 14.4) (p = 0.01). At a final follow-up, 90% of professional athletes (19 of 21) were still competing in athletic activity or still able to participate in unrestricted activity. Of the recreational athletes, 87% (13 of 15) had full return to pre-injury activity levels, while two (13%) returned to activity with restrictions or reduced intensity. MRI showed cystic change in 33% of patients post-operatively; however, this did not appear to affect outcomes (n.s.). Donor site symptoms were seen in 11% of the cohort at final follow-up, despite high function at donor knee.
  
  
  CONCLUSIONS
  The results of our study indicate that AOT procedure is able to achieve good outcomes in an athletic population at a midterm follow-up.
  
  
  METHODS
  Retrospective case series, Level IV.
authors.affiliation: Office of Dr JG Kennedy, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Fraser
authors.affiliation: Office of Dr JG Kennedy, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Harris
authors.affiliation: Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein, São Paulo, Brazil.
authors.forename: Marcelo P
authors.initials: MP
authors.lastname: Prado
authors.affiliation: Office of Dr JG Kennedy, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. KennedyJ@hss.edu.
authors.forename: John G
authors.initials: JG
authors.lastname: Kennedy
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery; D056352:Athletes; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010007:Osteochondritis / Q000503:physiopathology*; D012189:Retrospective Studies; D000068958:Return to Sport; D013628:Talus / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods / Q000534:rehabilitation; D055815:Young Adult
keywords: Ankle; Autograft; Osteochondral; Talus