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HemiCAP for Secondary Treatment for Osteochondral Talar Defects

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Arthroscopy

Abstract

The optimal treatment for large osteochondral defects of the talus or secondary defects has to be determined yet. A metal implant with a diameter of 15 mm has been developed for treatment of these lesions of the medial talar dome. We prospectively studied 20 consecutive patients for a mean of 4.5 years (3–5) post-surgery. There was statistically significant reduction of pain in rest, walking, and stair climbing (p ≤ 0.01). The median American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved from 62 (interquartile range (IQR), 46–72) preoperatively to 85 (IQR, 75–99) at final follow-up (p < 0.001). The Foot and Ankle Outcome Score improved on subscale pain, function, sports, and quality of life (p ≤ 0.01). The mean Short-Form 36 physical component scale improved from 36 (23–50) preoperatively to 45 (29–55) at final follow-up (p = 0.001); the mental component scale did not change significantly. On radiographs, progressive joint space narrowing of the ankle was observed in two patients. One patient required additional surgery for the osteochondral defect. The midterm results show that a metal implant is a promising treatment for osteochondral defects of the medial talar dome after failed previous surgery.

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References

  1. Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1055–68.

    Article  CAS  PubMed  Google Scholar 

  2. Anderson DD, Tochigi Y, Rudert MJ, Vaseenon T, Brown TD, Amendola A. Effect of implantation accuracy on ankle contact mechanics with a metallic focal resurfacing implant. J Bone Joint Surg Am. 2010;92:1490–500.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA. Complications of iliac crest bone graft harvesting. Clin Orthop Relat Res. 1996;329:300–9.

    Article  PubMed  Google Scholar 

  4. Baums MH, Heidrich G, Schultz W, Steckel H, Kahl E, Klinger HM. Autologous chondrocyte transplantation for treating cartilage defects of the talus. J Bone Joint Surg Am. 2006;88(2):303–8.

    Article  CAS  PubMed  Google Scholar 

  5. Canale ST, Belding RH. Osteochondral lesions of the talus. J Bone Joint Surg Am. 1980;62:97–102.

    CAS  PubMed  Google Scholar 

  6. Davidson PA, Rivenburgh D. Focal anatomic patellofemoral inlay resurfacing: theoretic basis, surgical technique, and case reports. Orthop Clin North Am. 2008;39:337–46.

    Article  PubMed  Google Scholar 

  7. Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME, Raikin SM. Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int. 2007;28:154–61.

    Article  PubMed  Google Scholar 

  8. Gaulrapp H, Hagena FW, Wasmer G. Postoperative evaluation of osteochondrosis dissecans of the talus with special reference to medial malleolar osteotomy. Z Orthop Ihre Grenzgeb. 1996;134:346–53.

    Article  CAS  PubMed  Google Scholar 

  9. Gautier E, Kolker D, Jakob RP. Treatment of cartilage defects of the talus by autologous osteochondral grafts. J Bone Joint Surg Br. 2002;84:237–44.

    Article  CAS  PubMed  Google Scholar 

  10. Haene R, Qamirani E, Story RA, Pinsker E, Daniels TR. Intermediate outcomes of fresh talar osteochondral allografts for treatment of large osteochondral lesions of the talus. J Bone Joint Surg Am. 2012;94:1105–10.

    Article  PubMed  Google Scholar 

  11. Hangody L, Kish G, Modis L, Szerb I, Gaspar L, Dioszegi Z, et al. Mosaicplasty for the treatment of osteochondritis dissecans of the talus: two to seven year results in 36 patients. Foot Ankle Int. 2001;22:552–8.

    CAS  PubMed  Google Scholar 

  12. Hasselman C, Shields N. Resurfacing of the first metatarsal head in the treatment of hallux rigidus. Tech Foot Ankle Surg. 2008;7:31–40.

    Article  Google Scholar 

  13. Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg. 2007;46:65–74.

    Article  PubMed  Google Scholar 

  14. Kappis M. Weitere Beiträge zur traumatisch-mechanischen Entstehung der “spontanen” Knorpelablösungen (sogen. Osteochondritis dissecans). Dtsch Z Chir. 1922;171:13–29.

    Article  Google Scholar 

  15. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349–53.

    Article  CAS  PubMed  Google Scholar 

  16. König F. Über freie Körper in den Gelenken. Dtsch Z Chir. 1888;27:90–109.

    Article  Google Scholar 

  17. Millington S, Grabner M, Wozelka R, Hurwitz S, Crandall J. A stereophotographic study of ankle joint contact area. J Orthop Res. 2007;25:1465–73.

    Article  PubMed  Google Scholar 

  18. Monro A. Microgeologie. Berlin. Th Billroth. 1856;1856:236.

    Google Scholar 

  19. Nosewicz TL, Reilingh ML, Wolny M, van Dijk CN, Duda GN, Schell H. Influence of basal support and early loading on bone cartilage healing in press-fitted osteochondral autografts. Knee Surg Sports Traumatol Arthrosc. 2014;22:1445–51.

    PubMed  Google Scholar 

  20. Paul J, Sagstetter A, Kriner M, Imhoff AB, Spang J, Hinterwimmer S. Donor-site morbidity after osteochondral autologous transplantation for lesions of the talus. J Bone Joint Surg Am. 2009;91:1683–8.

    Article  CAS  PubMed  Google Scholar 

  21. Reddy S, Pedowitz DI, Parekh SG, Sennett BJ, Okereke E. The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus. Am J Sports Med. 2007;35:80–5.

    Article  PubMed  Google Scholar 

  22. Reilingh ML, Blankevoort L, van Eekeren IC, van Dijk CN. Morphological analysis of subchondral talar cysts on microCT. Knee Surg Sports Traumatol Arthrosc. 2013;21:1409–17.

    Article  CAS  PubMed  Google Scholar 

  23. Reilingh ML, van Bergen CJ, van Dijk CN. Diagnosis and treatment of osteochondral defects of the ankle. South Afr Orthop J. 2009;8:44–50.

    Google Scholar 

  24. Roos EM, Brandsson S, Karlsson J. Validation of the foot and ankle outcome score for ankle ligament reconstruction. Foot Ankle Int. 2001;22:788–94.

    CAS  PubMed  Google Scholar 

  25. Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8:283–91.

    Article  PubMed  Google Scholar 

  26. Schachter AK, Chen AL, Reddy PD, Tejwani NC. Osteochondral lesions of the talus. J Am Acad Orthop Surg. 2005;13:152–8.

    Article  PubMed  Google Scholar 

  27. Scranton Jr PE, Frey CC, Feder KS. Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions of the talus. J Bone Joint Surg Br. 2006;88:614–9.

    Article  PubMed  Google Scholar 

  28. Uribe JW, Botto-van Bemden A. Partial humeral head resurfacing for osteonecrosis. J Shoulder Elbow Surg. 2009;18:711–6.

    Article  PubMed  Google Scholar 

  29. Valderrabano V, Leumann A, Rasch H, Egelhof T, Hintermann B, Pagenstert G. Knee-to-ankle mosaicplasty for the treatment of osteochondral lesions of the ankle joint. Am J Sports Med. 2009;37:105–11.

    Article  Google Scholar 

  30. van Bergen CJ, de Leeuw PA, van Dijk CN. Treatment of osteochondral defects of the talus. Rev Chir Orthop Reparatrice Appar Mot. 2008;94:398–408.

    Article  PubMed  Google Scholar 

  31. van Bergen CJ, Kox LS, Maas M, Sierevelt IN, Kerkhoffs GM, van Dijk CN. Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up. J Bone Joint Surg Am. 2013;95:519–25.

    Article  PubMed  Google Scholar 

  32. van Bergen CJ, Reilingh ML, van Dijk CN. Tertiary osteochondral defect of the talus treated by a novel contoured metal implant. Knee Surg Sports Traumatol Arthrosc. 2011;19:999–1003.

    Article  PubMed  PubMed Central  Google Scholar 

  33. van Bergen CJ, Tuijthof GJ, Reilingh ML, van Dijk CN. Clinical tip: aiming probe for a precise medial malleolar osteotomy. Foot Ankle Int. 2012;33:764–6.

    Article  PubMed  Google Scholar 

  34. van Bergen CJ, Tuijthof GJ, Sierevelt IN, van Dijk CN. Direction of the oblique medial malleolar osteotomy for exposure of the talus. Arch Orthop Trauma Surg. 2011;131:893–901.

    Article  PubMed  PubMed Central  Google Scholar 

  35. van Bergen CJ, van Eekeren IC, Reilingh ML, Sierevelt IN, van Dijk CN. Treatment of osteochondral defects of the talus with a metal resurfacing inlay implant after failed previous surgery: a prospective study. Bone Joint J. 2013;95:1650–5.

    Article  PubMed  Google Scholar 

  36. van Bergen CJ, Zengerink M, Blankevoort L, van Sterkenburg MN, van Oldenrijk J, van Dijk CN. Novel metallic implantation technique for osteochondral defects of the medial talar dome. A cadaver study. Acta Orthop. 2010;81:495–502.

    Article  PubMed  PubMed Central  Google Scholar 

  37. van Dijk CN, Reilingh ML, Zengerink M, van Bergen CJ. Osteochondral defects in the ankle: why painful? Knee Surg Sports Traumatol Arthrosc. 2010;18:570–80.

    Article  PubMed  PubMed Central  Google Scholar 

  38. van Dijk CN, Verhagen RA, Tol JL. Arthroscopy for problems after ankle fracture. J Bone Joint Surg Br. 1997;79:280–4.

    Article  PubMed  Google Scholar 

  39. Van Stralen RA, Haverkamp D, van Bergen CJ, Eijer H. Partial resurfacing with varus osteotomy for an osteochondral defect of the femoral head. Hip Int. 2009;19:67–70.

    PubMed  Google Scholar 

  40. Wan L, de Asla RJ, Rubash HE, Li G. In vivo cartilage contact deformation of human ankle joints under full body weight. J Orthop Res. 2008;26:1081–9.

    Article  PubMed  Google Scholar 

  41. Zengerink M, Struijs PA, Tol JL, van Dijk CN. Treatment of osteochondral lesions of the talus: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2010;18:238–46.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Zengerink M, Szerb I, Hangody L, Dopirak RM, Ferkel RD, van Dijk CN. Current concepts: treatment of osteochondral ankle defects. Foot Ankle Clin. 2006;11:331–59.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, 22660, 1100 DD, Amsterdam, The Netherlands

    Mikel L. Reilingh MD

  2. Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands

    Christiaan J. A. van Bergen MD, PhD, Rogier M. Gerards MD, Inge C. M. van Eekeren MD & C. Niek van Dijk MD, PhD

Authors
  1. Mikel L. Reilingh MD
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  2. Christiaan J. A. van Bergen MD, PhD
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  3. Rogier M. Gerards MD
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  4. Inge C. M. van Eekeren MD
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  5. C. Niek van Dijk MD, PhD
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Corresponding author

Correspondence to Mikel L. Reilingh MD .

Editor information

Editors and Affiliations

  1. San Donato Milanese, Milano, Italy

    Pietro Randelli

  2. Lyon, France

    David Dejour

  3. Academic Med Ctr, Orthopedic Surger, Univ of Amsterdam, Amsterdam, The Netherlands

    C. Niek van Dijk

  4. Istituto Clinico Humanitas, Rozzano, Milan, Italy

    Matteo Denti

  5. Dept Orthopedic Surgery & Sports Meds, Ctr Hospitalier Clinique d’Eich, Luxemburg, Luxembourg

    Romain Seil

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© 2016 ESSKA

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Reilingh, M.L., van Bergen, C.J.A., Gerards, R.M., van Eekeren, I.C.M., van Dijk, C.N. (2016). HemiCAP for Secondary Treatment for Osteochondral Talar Defects. In: Randelli, P., Dejour, D., van Dijk, C., Denti, M., Seil, R. (eds) Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49376-2_84

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  • DOI: https://doi.org/10.1007/978-3-662-49376-2_84

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49374-8

  • Online ISBN: 978-3-662-49376-2

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