Abstract

Arthroscopy of the ankle with micro-fracture technique is one way to initially treat symptomatic talar dome lesions. Human amniotic allograft has been used in similar bone, soft tissue and cartilage defects to aid in healing of tissue using graft cells that have not differentiated into a particular cell line. Patients were taken from the primary surgeon’s practice to include those who had undergone arthroscopy with micro-fracture technique for treatment of a talar dome lesion less than 2 cm2. 101 patient surgeries were completed arthroscopically without additional major procedures. 54 surgeries were completed with human amniotic allograft; 47 were completed without (control group). Modified ACFAS ankle scores were taken pre-operatively, 3, 12 and 24 months post-operatively. Visual analog pain scores were taken pre-operatively and 24 months post-operatively. Results comparing pre-operative modified ACFAS scores between the control and graft groups were not significantly different (p = 0.14). There was a significant improvement in both groups’ scores following ankle arthroscopy with micro-fracture as expected. However, the amniotic tissue group did significantly better when comparing the post-operative scores between the control and graft group. Pain scores comparing control and amniotic patient groups were significant (p 2, significantly improves the patients’ pain and ACFAS scores.

Highlights

  • Osteochondritis dissecans (OCD) is a general term used for describing cartilaginous full-thickness defects of a joint surface

  • The Human amniotic allografts (HAA) group had 54 patients with a talar dome lesion less than 2 cm2 but incorporated a human amniotic allograft to assist in healing and regeneration of cartilage

  • A significantly statistical improvement post-operatively was found from the preoperative status between the control group without HAA and the treatment group with HAA

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Summary

Introduction

Osteochondritis dissecans (OCD) is a general term used for describing cartilaginous full-thickness defects of a joint surface. These osteochondral defects or trans-chondral fracture (TCF) can present acute or sub-acute and present as one of the most challenging conditions to treat in the ankle. Since 1959 when the Bernt and Hardy Classification system was presented, TCF can be categorized and usually attributed to a traumatic event. These kinds of fractures in the ankle can be problematic and difficult to treat, especially when they become symptomatic [3] [4]. The authors, having used arthroscopy with micro-fracture technique extensively over many years and found initial results to be good, were looking to improve upon the technique being unsatisfied with patient’s two-year outcomes

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