Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus in an Athletic Population

Abstract

IntroductionThe purpose of the current study was to assess the rates of return to activity, in an athletic population, after treatment of talar OCL with autologous osteochondral transplantation (AOT), while assessing predictive factors for poor outcome.MethodsThirty-six patients underwent AOT procedure for OLT were identified for inclusion in this study, and demographic information was extracted. Pre-operative MRIs were performed on all patients to confirm the diagnosis of OLT and for surgical planning. Patients underwent one year follow-up MRI to assess the graft site for bony and cartilaginous integration, cyst formation and malleolar osteotomy union. Outcomes were assessed using the AOFAS scoring system. All patients were assessed at final follow-up for complications and functional outcomes, including return to activity.ResultsThe mean age of the study group was 31 years, 66% male. The mean AOFAS score for the 36 patients improved from 65.53 to 89.44 (p=ConclusionAutologous osteochondral transplantation resulted in high rates of return to activity in an athletic population. While donor site morbidity at final follow up was seen in over 10% of patients, this was not found to affect rates of return to sport. Cystic change was seen to be substantial at 33% on follow-up imaging, although was not significantly associated with poorer outcomes. These results indicate that AOT is a viable option for treating osteochondral lesions in an active population, with good return to activity achieved. IntroductionThe purpose of the current study was to assess the rates of return to activity, in an athletic population, after treatment of talar OCL with autologous osteochondral transplantation (AOT), while assessing predictive factors for poor outcome. The purpose of the current study was to assess the rates of return to activity, in an athletic population, after treatment of talar OCL with autologous osteochondral transplantation (AOT), while assessing predictive factors for poor outcome. MethodsThirty-six patients underwent AOT procedure for OLT were identified for inclusion in this study, and demographic information was extracted. Pre-operative MRIs were performed on all patients to confirm the diagnosis of OLT and for surgical planning. Patients underwent one year follow-up MRI to assess the graft site for bony and cartilaginous integration, cyst formation and malleolar osteotomy union. Outcomes were assessed using the AOFAS scoring system. All patients were assessed at final follow-up for complications and functional outcomes, including return to activity. Thirty-six patients underwent AOT procedure for OLT were identified for inclusion in this study, and demographic information was extracted. Pre-operative MRIs were performed on all patients to confirm the diagnosis of OLT and for surgical planning. Patients underwent one year follow-up MRI to assess the graft site for bony and cartilaginous integration, cyst formation and malleolar osteotomy union. Outcomes were assessed using the AOFAS scoring system. All patients were assessed at final follow-up for complications and functional outcomes, including return to activity. ResultsThe mean age of the study group was 31 years, 66% male. The mean AOFAS score for the 36 patients improved from 65.53 to 89.44 (p= The mean age of the study group was 31 years, 66% male. The mean AOFAS score for the 36 patients improved from 65.53 to 89.44 (p= ConclusionAutologous osteochondral transplantation resulted in high rates of return to activity in an athletic population. While donor site morbidity at final follow up was seen in over 10% of patients, this was not found to affect rates of return to sport. Cystic change was seen to be substantial at 33% on follow-up imaging, although was not significantly associated with poorer outcomes. These results indicate that AOT is a viable option for treating osteochondral lesions in an active population, with good return to activity achieved. Autologous osteochondral transplantation resulted in high rates of return to activity in an athletic population. While donor site morbidity at final follow up was seen in over 10% of patients, this was not found to affect rates of return to sport. Cystic change was seen to be substantial at 33% on follow-up imaging, although was not significantly associated with poorer outcomes. These results indicate that AOT is a viable option for treating osteochondral lesions in an active population, with good return to activity achieved.