Anterolateral tibial osteotomy and osteochondral transplantation for talar lesions

Abstract

Objective To evaluate the clinical effects of autologous osteochondral transplantation for talar lesions after anterolateral tibial osteotomy. Methods Between October 2011 and June 2015, 10 patients with osteochondral lesions on the lateral talar dome underwent autologous osteochondral transplantation after anterolateral tibial osteotomy. All donor grafts were harvested from the lateral femoral condyle of the ipsilateral knee. They were 6 men and 4 women, aged from 25 to 54 years(average 35.8 years). According to Hepple classification, 7 patients belonged to stage Ⅴ and 3 to stage Ⅳ. The lesion areas ranged from 110 mm2 to 247 mm2, averaging 178.6 mm2; the lesion depths ranged from 6 mm to 11 mm, averaging 7.8 mm. The ankle function and pain were assessed according to American Orthopaedic Foot and Ankle Society (AOFAS) an-kle-hindfoot score and visual analogue scale (VAS) preoperatively and postoperatively. Results The 8 pa-tients were followed up for an average of 31.6 months (from 18 to 51 months). All the patients achieved bone union 6 weeks after operation and were free of infection, malunion or hardware failure. The average AOFAS and VAS scores were improved from preoperative 65.5 and 6.9 to 91.3 and 1.3 at the last follow-up, re-spectively. Four cases were rated as excellent and 4 as good. Conclusions Anterolateral tibial osteotomy can provide excellent exposure of the lateral talar lesions for autologous osteochondral transplantation without problems related to the osteotomy itself. Also it may lead to good functional recovery in a short term. Key words: Talus; Wounds and injuries; Osteotomy; Transplantation, autologous