title: Management of Hepple Stage V Osteochondral Lesion of the Talus with a Platelet-Rich Plasma Scaffold.
abstract: There has been no consensus on the treatment or prognosis of Hepple stage V osteochondral lesions of the talus (OLTs), especially for lesions greater than 1.5 cm2in size. The objective of this study was to investigate the clinical outcomes achieved upon application of a platelet-rich plasma (PRP) scaffold with a cancellous bone autograft for Hepple stage V OLTs. Fourteen patients (mean age, 39 years) were treated with a cancellous bone graft and a PRP scaffold between 2013 and 2015. The mean time to surgical treatment was 23.5 months. Ankle X-ray and magnetic resonance imaging were performed at the final follow-up. Functional outcomes were evaluated according to the Visual Analog Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Short Form 36 (SF-36) score. The range of motion (ROM) of the ankle joint and complications also were recorded. Thirteen patients completed the full follow-up, with a mean follow-up duration of 18 months. MRI demonstrated the complete regeneration of subchondral bone and cartilage in all patients. The postoperative VAS, AOFAS ankle and hindfoot, and SF-36 scores were improved significantly (allP< 0.001) without obvious complications. We suggest that, for the Hepple stage V OLTs, management with cancellous bone graft and PRP scaffold may be a safe and effective treatment.
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Wenqi
authors.initials: W
authors.lastname: Gu
authors.affiliation: The People's Hospital of Shigatse City, Shigatse, Tibet 857000, China.
authors.forename: Tanzhu
authors.initials: T
authors.lastname: Li
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Zhongmin
authors.identifier: 0000-0002-2467-8735
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Mei
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Xue
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zou
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Xiaokang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Haotong
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Xu
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods; D001861:Bone Regeneration; D016025:Bone Transplantation; D002358:Cartilage, Articular / Q000254:growth & development / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055034:Osteochondrosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D053657:Platelet-Rich Plasma; D011379:Prognosis; D013628:Talus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D054457:Tissue Scaffolds; D016896:Treatment Outcome