Autologous osteochondral transplantation for osteochondral lesions of the talus in an athletic population

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2016-04, Vol.24 (4), p.1272-1279
• Main Authors: Fraser, Ethan J., Harris, Mark C., Prado, Marcelo P., Kennedy, John G.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Ankle; Ankle Joint - physiopathology; Ankle Joint - surgery; Athletes; Cartilage; Clinical outcomes; Female; Hospitals; Humans; Knee; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Orthopedics; Osteochondritis - physiopathology; Patients; Retrospective Studies; Return to Sport; Sports injuries; Surgeons; Surgery; Systematic review; Talus - surgery; Transplantation, Autologous - methods; Transplantation, Autologous - rehabilitation; Young Adult
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-015-3606-8

Purpose To assess clinical outcomes and return to sport in an athletic population treated with autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus. Methods A total of 36 patients were included in this retrospective study including 21 professional athletes and 15 amateur athletes who participated in regular moderate- or high-impact athletic activity. All patients underwent autologous osteochondral transplantation of the talus under the care of a single surgeon. At a mean follow-up of 5.9 years, patients were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system. All patients also received pre-operative MRI with the follow-up MRI performed at 1 year and underwent assessment of return to athletic activity. Results The overall AOFAS score improved from 65.5 (SD ± 11.1) to 89.4 (SD ± 14.4) ( p  = 0.01). At a final follow-up, 90 % of professional athletes (19 of 21) were still competing in athletic activity or still able to participate in unrestricted activity. Of the recreational athletes, 87 % (13 of 15) had full return to pre-injury activity levels, while two (13 %) returned to activity with restrictions or reduced intensity. MRI showed cystic change in 33 % of patients post-operatively; however, this did not appear to affect outcomes (n.s.). Donor site symptoms were seen in 11 % of the cohort at final follow-up, despite high function at donor knee. Conclusion The results of our study indicate that AOT procedure is able to achieve good outcomes in an athletic population at a midterm follow-up. Level of evidence Retrospective case series, Level IV.