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Regenerative treatment of osteochondral lesions of distal tibial plafond

  • Original Article • ANKLE - ARTHROSCOPY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objectives

Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Literature data do not report clinical records with significant number of cases and follow-up. The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic treatment of distal tibia osteochondral lesions and to report our results with treating these rare lesions.

Methods

Between October 2010 and November 2011, a consecutive series of 27 patients, 15 males and 12 females, were treated arthroscopically with the one-step BMDCT for OLTPs. Exclusion criteria were: age < 18 or > 50 years, patients with severe osteoarthritis (stage III according to Van Dijk classification), presence of kissing lesions of the ankle and patients with rheumatoid or hemophilic arthritis. All patients were evaluated through X-rays; MRI was performed preoperatively and at the final follow-up with MOCART score; clinical evaluation was assessed by AOFAS score at various follow-ups of 12, 24, 36, 60 and 72 months.

Results

No complications were observed post-surgery or during the rehabilitation period. The AOFAS score improved from 52.4 preoperatively to 80.6 at the mean final follow-up. All the patients were satisfied with the procedure. In 14 cases the MRI showed a complete filling of the osteochondral defect, in three patients a hypertrophic tissue was observed, and in the other two patients an incomplete repair of the lesion associated with a persistent slight subchondral edema was reported. A topographic study was also performed.

Conclusions

Osteochondral lesions of the distal tibia represent a challenge for the orthopedic surgeon because of their difficulty diagnostic and rarities. The high incidence of good outcome in our series indicates that the one-step BMDCT could be a valid option for the treatment of this rare type of lesions. Further studies with a longer follow-up and more accurate imaging studies are necessary to confirm these results.

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Authors and Affiliations

  1. I Clinic, Rizzoli Orthopedic Institute of Bologna, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy

    Matteo Baldassarri, Luca Perazzo, Marco Ricciarelli, Simone Natali, Francesca Vannini & Roberto Buda

Authors
  1. Matteo Baldassarri
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  2. Luca Perazzo
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  3. Marco Ricciarelli
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  4. Simone Natali
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  5. Francesca Vannini
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  6. Roberto Buda
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Correspondence to Matteo Baldassarri.

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Baldassarri, M., Perazzo, L., Ricciarelli, M. et al. Regenerative treatment of osteochondral lesions of distal tibial plafond. Eur J Orthop Surg Traumatol 28, 1199–1207 (2018). https://doi.org/10.1007/s00590-018-2161-7

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  • DOI: https://doi.org/10.1007/s00590-018-2161-7

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