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Archives of Orthopaedic and Trauma Surgery

, Volume 128, Issue 5, pp 499–504 | Cite as

No mid-term difference in mosaicplasty in previously treated versus previously untreated patients with osteochondral lesions of the talus

  • Carl HaasperEmail author
  • Boris A. Zelle
  • Karsten Knobloch
  • Michael Jagodzinski
  • Musa Citak
  • Joachim Lotz
  • Christian Krettek
  • Johannes Zeichen
Arthroscopy and Sports Medicine

Abstract

Introduction

Osteochondral transplantations, albeit technically challenging, appear promising not only in knee joint lesions, but also in the treatment of talus lesions. We hypothesized that in patients suffering osteochondral lesions of the talus, favorable outcomes are obtained in patients undergoing primary mosaicplasty as compared to patients undergoing secondary mosaicplasty.

Materials and methods

Over a 3-year period (1998–2001), 14 patients (six male, eight female, median age 22 years) were treated with an autologous osteochondral transplantation of the talus. Eight patients were previously untreated (group I). Six patients had previous ankle procedures, such as microfracturing (group II). The median follow-up was 24 months and 100% complete at 12 months. The functional outcome was evaluated at least at 6 weeks, 12 weeks, and 1 year after surgery using pain on a visual analog scale (VAS) and sports activity was recorded at 1 year after surgery. In ten patients, magnetic resonance imaging (MRI) of the ankle was performed at 1 year after surgery (group I/II: 7/3).

Results

Overall ankle pain was decreased from 6.9 ± 2.1 to 4.0 ± 2.8 postoperatively. The mean knee pain for the donor knee was 2.6 ± 2.4. We found no significant difference between the primary mosaicplasty group and the secondary mosaicplasty group with regard to pain. MRI scans of ten patients showed a complete incorporation of the osteochondral cylinders at 1 year after surgery.

Conclusion

Favorable outcomes were obtained in patients undergoing primary mosaicplasty as compared to patients undergoing secondary mosaicplasty. We found no significant difference among patients with previous ankle surgery in contrast to those without, with a median 24-months follow-up.

Keywords

Cartilage lesion Osteochondral transplantation Ankle joint Microfracture Arthroscopy 

References

  1. 1.
    Baltzer AW, Arnold JP (2005) Bone-cartilage transplantation from the ipsilateral knee for chondral lesions of the talus. Arthroscopy 21:159–166PubMedCrossRefGoogle Scholar
  2. 2.
    Evans CH (2005) Novel biological approaches to the intra-articular treatment of osteosarthritis. Biodrugs 19:355–362PubMedCrossRefGoogle Scholar
  3. 3.
    Giannini S, Vannini F (2004) Operative treatment of osteochondral lesions of the talar dome: current concepts review. Foot Ankle Int 25:168–175PubMedGoogle Scholar
  4. 4.
    Giannini S, Vannini F, Buda R (2002) Osteoarticular grafts in the treatment of OCD of the talus: mosaicplasty versus autologous chondrocyte transplantation. Foot Ankle Clin 7:621–633PubMedCrossRefGoogle Scholar
  5. 5.
    Hangody L (2003) The mosaicplasty technique for osteochondral lesions of the talus. Foot Ankle Clin 8:259–273PubMedCrossRefGoogle Scholar
  6. 6.
    Hangody L, Fules P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am 85-A(Suppl 2):25–32PubMedGoogle Scholar
  7. 7.
    Kish G, Modis L, Hangody L (1999) Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete. Rationale, indications, techniques, and results. Clin Sports Med 18:45–66, viPubMedCrossRefGoogle Scholar
  8. 8.
    Kolker D, Murray M, Wilson M (2004) Osteochondral defects of the talus treated with autologous bone grafting. J Bone Joint Surg Br 86:521–526PubMedGoogle Scholar
  9. 9.
    Kreuz PC, Steinwachs M, Erggelet C, Lahm A, Henle P, Niemeyer P (2006) Mosaicplasty with autogenous talar autograft for osteochondral lesions of the talus after failed primary arthroscopic management: a prospective study with a 4-year follow-up. Am J Sports Med 34:55–63PubMedCrossRefGoogle Scholar
  10. 10.
    Seil R, Kohn D (2001) Osteochondral lesions of the talus––a rarity? Orthopade 30:1–2PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Carl Haasper
    • 1
    Email author
  • Boris A. Zelle
    • 1
  • Karsten Knobloch
    • 1
  • Michael Jagodzinski
    • 1
  • Musa Citak
    • 1
  • Joachim Lotz
    • 2
  • Christian Krettek
    • 1
  • Johannes Zeichen
    • 1
  1. 1.Trauma DepartmentHannover Medical School (MHH)HannoverGermany
  2. 2.Department of Diagnostic RadiologyHannover Medical School (MHH)HannoverGermany

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