Mid-and-long-term outcomes of autologous osteochondral transplantation for Hepple Ⅴ osteochondral lesions of the talus
Objective:To analyze the mid-and-long-term outcomes of autologous osteochondral transplantation for Hepple Ⅴosteochondral lesions of the talus.Methods:From March 2016 to November 2017,the clinical data of 20 patients with Hepple Ⅴosteochondral lesions of the talus who were treated with autologous osteochondral transplantation in Peking University Third Hospital were retrospectively analyzed.There were 13 males and 7 females with an average age of(37.7±8.8)years(range,18-53 years).The visual analog scale(VAS)score,American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot score,and ankle activity scale(AAS)were assessed and compared preoperatively and at the final follow-up.The International Cartilage Repair Society(ICRS)score from the second-look arthroscopy and the cartilage repair MR score(MOCART)from the last magnetic resonance imaging(MRI)examination were evaluated.The incidence of donor-site complications was recorded,and the Lysholm score was used to evaluate knee joint function.Results:Twenty patients were followed up for a period ranging from 60.9 to 81.9 months,with an average follow-up duration of 71.3±6.8 months.At the final follow-up,significant improvements were observed in VAS,AOFAS and AAS scores compared to preoperative values(all P<0.001).At the final follow-up,the AOFAS ankle-hindfoot score was excellent in 16 cases,good in 3 cases,and fair in 1 case.All 20 patients underwent postoperative ankle MRI,with an average MOCART score of 72.5±7.5;11 patients(55.0%)underwent second-look arthroscopy,and the ICRS score was 9.7±0.9.Six patients(30.0%)had mild discomfort in the knee bone graft area.At the final follow-up,the VAS score for the ipsilateral knee was 0.0(0.0,0.0),and the Lysholm score was 96.5(92.0,99.5).Conclusions:Autologous osteochondral transplantation has good mid-and long-term outcomes in the treatment of Hepple type Ⅴ talar osteochondral lesions.Both arthroscopic and imaging results indicate satisfactory repair,confirming the procedure a safe and effective treatment method.
Osteochondral Lesions of the TalusHepple ⅤAutologous Osteochondral TransplantationDonor-site Morbidity
NETL
NSTL
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