Good clinical and functional outcomes at mid-term following autologous osteochondral transplantation for osteochondral lesions of the talus

  • Yoshiharu Shimozono
  • Eoghan T. Hurley
  • Charles L. Myerson
  • John G. Kennedy
Ankle
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Abstract

Purpose

Autologous osteochondral transplantation is an established treatment for large-sized osteochondral lesions of the talus (OLT) with excellent short term outcomes. However, few studies assess the outcomes of autologous osteochondral transplantation at mid-term follow-up. The purpose of the current systematic review was to evaluate the clinical outcomes of the autologous osteochondral transplantation procedure in the treatment of OLT at mid-term and long-term follow-up.

Methods

A systematic search of the MEDLINE, EMBASE and Cochrane Library databases was performed in October 2017 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were evaluated with regard to level of evidence (LOE) and quality of evidence (QOE) using the Coleman Methodology Score. Clinical outcomes, and complications were also evaluated.

Results

Eleven studies, with 500 ankles were included at a mean 62.8 months follow-up. Seven studies used the American Orthopaedic Foot and Ankle Society (AOFAS) score. The weighted mean preoperative AOFAS score was 55.1 ± 6.1, and the postoperative score was 86.2 ± 4.5, with 87.4% of patients (132 of 151) being reported as excellent or good results. In total, 53 of the 500 patients (10.6%) had complications. The most common complication was donor site morbidity with 18 patients (3.6%) at final follow-up. Thirty-one patients (6.2%) underwent reoperations, and 5 ankles (1.0%) were regarded as failed autologous osteochondral transplantation.

Conclusion

The current systematic review demonstrated that good clinical and functional outcomes can be expected following autologous osteochondral transplantation for the treatment of OLT, with a low failure rate. The results from this study show patients can be reasonably counselled to expect good clinical outcomes in the mid-term. MRI and radiographs showed restoration of articular surface as well as a minimal presence of osteoarthritis at mid-term follow-up. However, as low level and quality of evidence and the variability of the data may confound the data, further well-designed studies are necessary to determine the effectiveness of autologous osteochondral transplantation in the treatment for OLT.

Level of evidence

IV.

Keywords

Autograft Osteochondral Review Talus 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This manuscript is a systematic review and does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Yoshiharu Shimozono
    • 1
    • 2
    • 3
  • Eoghan T. Hurley
    • 1
    • 4
  • Charles L. Myerson
    • 1
    • 5
  • John G. Kennedy
    • 1
  1. 1.Hospital for Special SurgeryNew YorkUSA
  2. 2.Department of Orthopaedic SurgeryTeikyo University School of MedicineTokyoJapan
  3. 3.Department of Orthopaedic SurgeryKyoto University Graduate School of MedicineKyotoJapan
  4. 4.Royal College of Surgeons in IrelandDublinIreland
  5. 5.Tulane University School of MedicineNew OrleansUSA

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