Outcomes of talar dome osteochondral defect repair using osteocartilaginous autografts: 37 cases of Mosaicplasty®

Abstract

BackgroundThe indications of osteochondral autograft implantation using the Mosaicplasty® technique were only recently extended to osteochondral lesions of the talus (OLT), a site for which no medium- or long-term outcome data are available. Our objective here was to evaluate medium-term outcomes in case-series of patients who underwent Mosaicplasty® for OLT repair. HypothesisMosaicplasty® provides good medium-term outcomes with low morbidity when used for OLT repair. Patients et methodsWe retrospectively reviewed cases of Mosaicplasty® for OLT repair, performed in combination with malleolar osteotomy on the side of the OLT, at either of two centres, between 1997 and 2013. Pre-operative clinical data were collected from the medical records and all patients were re-evaluated. We studied 37 patients with a mean age of 33 years. ResultsMean follow-up at re-evaluation was 76 months. Mean AOFAS score at re-evaluation was 83 (range, 9–100). A work-related cause to the OLT was associated with significantly poorer outcomes (P=0.01). AOFAS values were significantly better in patients whose OLT size was 0.5 to 1cm2. The Ogilvie-Harris score at last follow-up was good or excellent in 78% of patients. No patient experienced morbidity related to the malleolar osteotomy. Persistent patellar syndrome was noted in 6 patients. DiscussionIn our case-series, Mosaicplasty® for OLT repair provided good medium-term outcomes in 78% of patients. Nevertheless, the donor-site morbidity should be borne in mind. Mosaicplasty® deserves to be viewed as a reference standard method for OLT repair. Level of evidenceIV, retrospective study.