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Clinical Orthopaedics and Related Research®

, Volume 469, Issue 8, pp 2356–2366 | Cite as

Does Fresh Osteochondral Allograft Transplantation of Talar Osteochondral Defects Improve Function?

  • Gregory C. BerletEmail author
  • Christopher F. Hyer
  • Terrence M. Philbin
  • Jodi F. Hartman
  • Michelle L. Wright
Clinical Research

Abstract

Background

Fresh osteochondral allograft transplantation can be used to replace talar osteochondral defects (OCDs) with single bulk osteochondral graft. While limited studies report improvement of function, improvement in quality of life and radiographic durability is unknown.

Questions/purpose

We therefore determined if this technique improved function, increased quality of life, and provided durable graft stability radiographically and by MRI.

Patients and Methods

We prospectively followed 19 patients (19 OCDs). We excluded seven patients (four with insufficient followup, two who were lost to followup, and one with graft failure), leaving 12 patients with a minimum followup of 2 years (average, 3.3 years; range, 2.0–4.6 years). Functional and quality of life outcomes were quantified using the American Orthopaedic Foot and Ankle Society (AOFAS) score and the SF-12 Health Survey. Graft incorporation and stability were assessed through radiographs and MRI.

Results

Mean total AOFAS scores (61 ± 9 to 79 ± 6), pain subscores (17 ± 8 versus 26 ± 5), and function subscores (34 ± 3 versus 42 ± 4) improved from preoperatively to last followup. We observed no improvements of the physical and mental health components of the SF-12 Health Survey from preoperatively to last followup. At last followup, three of the 12 grafts had radiolucencies, four had edema, one failed to incorporate, and none had subsidence. One of the 19 patients in the overall series underwent graft revision.

Conclusions

Patients with talar OCDs can expect functional improvement after this technique. The majority will have stable grafts at least short term. Larger studies with longer followup are needed to determine if this procedure substantially improves quality of life, if graft radiolucencies and edema have any long-term implications, and whether the grafts are durable.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Autologous Chondrocyte Implantation Total Ankle Arthroplasty Osteochondral Allograft Mental Health Component Graft Incorporation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

We thank Peter B. Maurus MD, for his medical illustration.

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Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Gregory C. Berlet
    • 1
    Email author
  • Christopher F. Hyer
    • 1
  • Terrence M. Philbin
    • 1
  • Jodi F. Hartman
    • 2
  • Michelle L. Wright
    • 2
  1. 1.Orthopedic Foot and Ankle CenterWestervilleUSA
  2. 2.Orthopaedic Research & Reporting, LtdGahannaUSA

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