All-Arthroscopic Autologous Cancellous Bone Transplantation Achieves Favorable Functional Improvements and Radiographic Recovery in Large Cystic Osteochondral Lesions of the Talus at a Minimum 12-Month Follow-Up.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
PURPOSE: To evaluate short-term clinical and radiographic outcomes of all-arthroscopic autologous cancellous bone transplantation in addressing large cystic osteochondral lesions of the talus with cyst diameter ≥10 mm and cyst depth ≥6 mm. METHODS: A retrospective analysis was carried out among consecutive patients who underwent arthroscopic cancellous bone transplantation by 1 senior surgeon between January 2020 and September 2023 using autografts from the ipsilateral Gerdy's tubercle. A minimum follow-up of 12 months was required for inclusion. Patient-reported outcome measures were evaluated preoperatively and at the latest follow-up, including the American Orthopaedic Foot & Ankle Society score, visual analogue scale, ankle activity score, and Foot and Ankle Outcome Score, with minimal clinically important difference analyzed of each scale. Subjective satisfaction was assessed with a 0-to-10 scale. Return-to-sports rate and representative sports level were recorded. The Magnetic Resonance Observation of Cartilage Repair Tissue score was evaluated based on postoperative magnetic resonance imaging. RESULTS: Overall, 45 patients (45 ankles) were included. Mean follow-up duration was 27.6 ± 9.9 months (range, 14.7-48.0 months). Average diameter and depth of subchondral cysts were 13.5 ± 2.9 and 8.4 ± 1.6 mm. Patient-reported outcome measures were significantly improved: American Orthopaedic Foot & Ankle Society, from 53.9 ± 15.6 to 88.2 ± 9.8; visual analogue scale, from 7.9 ± 0.8 to 2.0 ± 1.0; ankle activity score, from 2.3 ± 1.1 to 4.0 ± 1.4; and Foot and Ankle Outcome Score, from 59.0 ± 7.8 to 83.1 ± 12.1 (P < .001 for all). Subjective satisfaction was 8.9 ± 1.1. Percentages of patients exceeding minimal clinically important differences of the American Orthopaedic Foot & Ankle Society, visual analogue scale, ankle activity score, and Foot and Ankle Outcome Score were 97.8%, 100.0%, 75.6%, and 88.9%, respectively. Return-to-sports rate was 64.5%, and 32.3% resumed preinjury level. The Magnetic Resonance Observation of Cartilage Repair Tissue score was 80.8 ± 12.0 at 19-month follow-up, with complete filling of the defects observed in 71.8% and complete integration in 79.5% patients. CONCLUSIONS: In treatment of osteochondral lesions of the talus with large subchondral cysts, all-arthroscopic autologous cancellous bone transplantation showed favorable clinical and radiologic outcomes at a minimum 12-month follow-up, achieving significant improvements in patient-reported outcome measures and a mean Magnetic Resonance Observation of Cartilage Repair Tissue score of 80.8, although the return-to-sports rate remained modest at 64.5%. LEVEL OF EVIDENCE: Level IV, retrospective case series.