title: Clinical and MRI Donor Site Outcomes Following Autologous Osteochondral Transplantation for Talar Osteochondral Lesions.
abstract: BACKGROUND
  Autologous osteochondral transplantation (AOT) has an inherent risk of donor site morbidity (DSM). The reported rates of DSM vary from 0% to 50%, with few studies reporting clinical or imaging outcomes at the donor site as a primary outcome and even fewer report these outcomes when a biosynthetic plug backfill is employed. Although TruFit (Smith & Nephew, Andover, MA) plugs have been removed from the market for regulatory purposes, biphasic plugs (including TruFit plugs) have been used for several years and the evaluation of these is therefore pertinent.
  
  
  METHODS
  Thirty-nine patients who underwent forty AOT procedures of the talus, with the donor graft being taken from the ipsilateral knee, were included. Postoperative magnetic resonance imaging (MRI) was used to assess the donor site graded with magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Lysholm scores were collected preoperatively, at the time of magnetic resonance imaging (MRI), and again at 24 months and at final follow-up to assess clinical outcomes. Statistical analysis was performed to establish if there was any correlation between MRI assessment of the donor site and clinical outcomes. The mean patient age was 36.2 ± 15.7 years with a mean follow-up of 41.8 ± 16.7 months.
  
  
  RESULTS
  All patient donor site defects were filled with OBI TruFit biphasic plugs. DSM was encountered in 12.5% of the patient cohort at 24 months, and in these patients, the Lysholm score was a mean 87.2 ± 5.0. At final follow-up, DSM was reduced to 5%. Lysholm scores for the entire cohort were 98.4 ± 4.6 and 99.4 ± 3.1 at 24 months and final follow-up, respectively. MRI of the donor sites were taken at an average of 18.1 ± 13.5 (range, 3-48) months postoperatively and the mean MOCART score was 60.0 ± 13.5. No correlation was found between the MOCART score and Lysholm outcomes at the donor knee (P = .43, r = 0.13).
  
  
  CONCLUSIONS
  Low incidence of DSM and good functional outcomes were achieved with AOT. Additionally, MRI findings did not predict clinical outcomes in our study.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Fraser
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Savage-Elliott
authors.affiliation: Hospital for Special Surgery, New York, NY, USA Teikyo University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan.
authors.forename: Youichi
authors.initials: Y
authors.lastname: Yasui
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Jakob
authors.initials: J
authors.lastname: Ackermann
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Watson
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Keir A
authors.initials: KA
authors.lastname: Ross
authors.affiliation: East River Medical Imaging, New York, NY, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Deyer
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: D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010007:Osteochondritis / Q000503:physiopathology*; D012189:Retrospective Studies; D013628:Talus / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods*
keywords: ankle; autologous; cartilage; chondral; donor site morbidity; osteochondral lesion; scaffolds; talus