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An anterior ankle arthroscopic technique for retrograde osteochondral autograft transplantation of posteromedial and central talar dome cartilage defects

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Abstract

Purpose

The purpose of this study was to present an arthroscopic technique for the treatment for posteromedial and central cartilage defects of the talus using anterior arthroscopic portals and without performing a medial malleolar osteotomy.

Methods

Nine fresh cadavers were dissected. Autografts were implanted under arthroscopy using a retrograde osteochondral transplantation system, and their position was estimated using specific angular calibrators and later confirmed by software analysis of two photographs of the disarticulated ankle joint.

Results

In eight cases, the congruence between the surrounding articular cartilage and the cartilage of the graft was high, with differences measuring <1 mm. There were no iatrogenic cartilage lesions of the tibial plafond and no fractures of the talus. All the autografts remained stable during full range of motion cycles of the ankle joint. One failure was reported.

Conclusion

This cadaveric study showed that the retrograde osteochondral autograft transplantation technique in the talus is feasible. It can be used to restore the posteromedial and central talar articular surfaces using conventional ankle arthroscopic instrumentation and anterior arthroscopic portals without resorting to a medial malleolar osteotomy. Further clinical and biomechanical studies are required to prove the efficacy of this technique and its reproducibility in routine clinical practice.

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Conflict of interest

PB is an occasional consultant of Smith and Nephew. No other conflict of interest relevant to this article was reported.

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Correspondence to Konstantinos G. Makridis.

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Wajsfisz, A., Makridis, K.G., Naji, O. et al. An anterior ankle arthroscopic technique for retrograde osteochondral autograft transplantation of posteromedial and central talar dome cartilage defects. Knee Surg Sports Traumatol Arthrosc 22, 1298–1303 (2014). https://doi.org/10.1007/s00167-013-2502-3

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Keywords

  • Osteochondral autograft transplantation
  • Retrograde technique
  • Talus
  • Cadaveric study
  • Anterior ankle portals