Osteochondral Defects of Talus treated with Juvenile Cartilage Transplant Cells

Abstract

To prove that Juvenile Cartilage cells have a role in the treatment of Osteochondral Defect (OCD) of the Talus. This is Retrospective case series with clinical follow up. We obtained appropriate IRB approval for reviewing our cases of OCD of Talus treated with transplanted cartilage cells. OCD of the Talus is initially treated with trial of splintage, activity modification, NSAIDS and Physical therapy. When patients do not respond to nonoperative measures the standard surgical intervention is debridement with or without micro-fracture or an OATS procedure In out Institution for the cases which needed surgical Intervention we treated them with an ankle arthroscopic debridement of the lesion and a synovectomy. We then proceeded to transplant juvenile allograft cartilage cells(Denovo, Zimmer) to cover the defect. Patients were nonweight bearing 2 weeks in a splint. Patients then were placed in a CAM walker for next 4 weeks with PWB and PT. Patients were evaluated postop and foot and ankle scores were obtained through a combination of clinical exam and telephonic questionnaire. we had total of seven cases between 2012 to 2016 with an average followup of 8 months. The first 2 cases had an arthroscopy - arthrotomy for cartilage cell transplant. The last 5 cases have all been performed arthroscopically. we had age range form 17 to 56 and both males( 5) and females( 2) At last followup 5 cases had an excellent result with a foot and ankle score over 97( 100) one patient had a fair result. FA score 75-80. One patient at 4 months complained that symptoms were no different at 4 month mark. FA Score 50. Early results for Cartilage cell transplants for OCD of the Talus have been good. We need a larger series and longer followup hopefully with a multicenre blinded trail to see if these results will be worth the extra cost and risks involved.