Abstract
One of the most challenging joint conditions facing ankle surgeons today is the treatment of Osteochondritis Dissecans (OCD) of the talar dome. The use of human amniotic allograft (HAA) in various surgical procedures, has been proven to facilitate bone growth and both soft tissue and cartilage healing. The authors of this paper propose the addition of HAA to the surgical repair of talar dome lesions to improve postoperative results, specifically pain reduction. For the study, 37 patients were identified having an OCD lesion of the talus measuring no larger than 2 cm2. All patients were treated surgically with an arthroscopic micro-fracture repair along with the addition of HHA. Modified ACFAS ankle scores were taken pre-operatively and at 3 months, 12 months, and at 24 months postoperatively. Visual analog scores were also taken preoperative and 24 months postoperatively. The size of the talar lesions documented with pre-operative MRI’s were compared with intra-operative measurements for each patient. Additional surgical repairs, comorbidities and any complications were also recorded and evaluated. All patients were treated with micro-fracture with HAA. Postoperative ACFAS scores for 3 months, 12 months and 24 months were significantly improved (p 2 have shown to significantly improve both post-operative VAS scores, when compared to pre-operative scores. This improvement in ACFAS and VAS scores speaks to the potential use of HAA in the treatment of OCD.
Highlights
Osteochondritis dissecans (OCD) broadly relates to loose bodies within a joint, in this particular study, the ankle joint
Berndt and Hardy classification system was described in 1959 and as trans-chondral fractures (TCF) that were associated with some type of traumatic event
Several surgical methods have been described such as a simple arthroscopic debridement with micro-fracture to open osteo-chondral grafting to ankle joint fusion or ankle arthroplasty [3]-[5]
Summary
Osteochondritis dissecans (OCD) broadly relates to loose bodies within a joint, in this particular study, the ankle joint. Berndt and Hardy classification system was described in 1959 and as trans-chondral fractures (TCF) that were associated with some type of traumatic event. Due to the functional demand of the ankle, even small lesions can become very symptomatic resulting in the need of surgical repair. Several surgical methods have been described such as a simple arthroscopic debridement with micro-fracture to open osteo-chondral grafting to ankle joint fusion or ankle arthroplasty [3]-[5]. Because of the weight baring function and the vascular status of the talus, it is generally believed that small lesions are best treated with a less invasive surgical approach
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