title: Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus.
abstract: BACKGROUND
  Autologous osteochondral transplantation (AOT) is used to treat osteochondral lesions (OCLs) of the talus, typically reserved for lesions greater than 150 mm(2). Few studies exist examining the functional and magnetic resonance imaging (MRI) outcomes following this procedure. The purpose of this study was to investigate functional and MRI outcomes, including quantitative T2 mapping following AOT.
  
  
  METHODS
  Eighty-five consecutive patients who underwent AOT were identified. Functional outcomes were assessed pre- and postoperatively using the Foot and Ankle Outcome Score (FAOS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess cartilage incorporation. Quantitative T2 MRI relaxation time of graft tissue and adjacent normal cartilage values were recorded in a subset of 61 patients. The mean clinical follow-up was 47.2 months, with mean MRI follow-up of 24.8 months.
  
  
  RESULTS
  Mean FAOS improved pre- to postoperatively from 50 to 81 (P < .001). The mean MOCART score was 85.8. Lesion size was negatively correlated with MOCART score (r = -0.36, P = .004). Superficial T2 values in graft tissue were higher than control tissue (42.0 vs 35.8, P < .001). Deep T2 values in graft tissue were similar to the control values (30.9 vs 30.0, P = .305). Functional outcomes were similar in patients irrespective of whether they had previous microfracture or concomitant procedures.
  
  
  CONCLUSIONS
  AOT was an effective treatment for large OCLs of the talus in the current study. MOCART scoring indicated good structural integrity of the graft. Quantitative T2 mapping suggests that graft tissue may not always mirror native hyaline cartilage. The long-term implications of this are not yet known.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Seán
authors.initials: S
authors.lastname: Flynn
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Keir A
authors.initials: KA
authors.lastname: Ross
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Hannon
authors.affiliation: Hospital for Special Surgery, New York, NY, USA Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Youichi
authors.initials: Y
authors.lastname: Yasui
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Hunter
authors.initials: H
authors.lastname: Newman
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Murawski
authors.affiliation: East River Imaging, New York, NY, USA.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Deyer
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Huong T
authors.initials: HT
authors.lastname: Do
authors.affiliation: Hospital for Special Surgery, New York, NY, USA kennedyj@hss.edu.
authors.forename: John G
authors.initials: JG
authors.lastname: Kennedy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002356:Cartilage / Q000637:transplantation*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D005269:Femur / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D063868:Patient Outcome Assessment; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D014182:Transplantation, Autologous; D051223:Trapezoid Bone / Q000601:surgery; D055815:Young Adult
keywords: MRI; Talus; osteochondral lesion; osteochondral transplantation