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Medium-term outcomes of mosaicplasty versus arthroscopic microfracture with or without platelet-rich plasma in the treatment of osteochondral lesions of the talus

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to compare medium-term functional effects of three different treatment modalities in patients with osteochondral lesions of the talus (OLT).

Methods

Fifty-four patients undergoing arthroscopic surgery for osteochondral lesion of the talus were included in this study. Patients were assigned to one of the three treatment groups: microfracture surgery (n = 19), microfracture surgery plus platelet-rich plasma (PRP) (n = 22), and mosaicplasty (n = 13). Function was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system and VAS scores for pain, before and after surgery. In addition, the Foot and Ankle Ability Measure (FAAM) tests for pain and 15-min walking were done at follow-up visits.

Results

The median duration of follow-up was 42 months (range 12–84 months). All groups showed significant improvements in AOFAS and VAS pain scores at the last follow-up visit, when compared to baseline. The groups did not differ with regard to change in baseline AOFAS score; however, improvement in VAS pain scores was significantly better in the mosaicplasty group when compared to the microfracture group (change from baseline, −5.8 ± 1.0 vs. −3.2 ± 2.9, p = 0.018).

Conclusions

All the three treatment modalities resulted in good medium-term functional results. However, mosaicplasty procedure seems to be a promising option and it might be preferred particularly in patients where pain control is important.

Level of evidence

II.

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References

  1. Buckwalter JA, Mow VC, Hunziker EB (2001) Concepts of cartilage repair in osteoarthritis. In: Moskowitz RW, Goldberg VM, Howell DS, Altman RD, Buckwalter JA (eds) Osteoarthritis: diagnosis and medical/surgical management, 3rd edn. WB Saunders Publishers, Philadelphia, pp 101–114

    Google Scholar 

  2. Doral MN, Atay A, Bilge O, Donmez G (2011) Current treatment approaches in chondral repair. Turk Geriatri Derg 4:95–100

    Google Scholar 

  3. Dozin B, Malpeli M, Cancedda R, Bruzzi P, Calcagno S, Molfetta L, Priano F, Kon E, Marcacci M (2005) Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: a multicentered randomized clinical trial. Clin J Sport Med 15:220–226

    Article  PubMed  Google Scholar 

  4. Emre TY, Ege T, Cift HT, Demircioglu DT, Seyhan B, Uzun M (2012) Open mosaicplasty in osteochondral lesions of the talus: a prospective study. J Foot Ankle Surg 51:556–560

    Article  PubMed  Google Scholar 

  5. Eppley BL, Woodell JE, Higgins J (2004) Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg 114:1502–1508

    Article  PubMed  Google Scholar 

  6. Gandhi A, van Gelderen J, Berberian WS (2003) Platelet releasate enhances healing in patients with a non-union. Paper presented at the Orthopaedic Research Society 49th Annual Meeting New Orleans, LA, 2 Feb 2003

  7. Giannini S, Buda R, Battaglia M, Cavallo M, Ruffilli A, Ramponi L, Pagliazzi G, Vannini F (2013) One-step repair in talar osteochondral lesions: 4-year clinical results and t2-mapping capability in outcome prediction. Am J Sports Med 41:511–518

    Article  PubMed  Google Scholar 

  8. Guney A, Akar M, Karaman I, Oner M, Guney B (2015) Clinical outcomes of platelet rich plasma (PRP) as an adjunct to microfracture surgery in osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 23:2384–2389

    Article  PubMed  Google Scholar 

  9. Hangody L, Rathonyi GK, Duska Z, Vasarhelyi G, Fules P, Modis L (2004) Autologous osteochondral mosaicplasty. Surgical technique. J Bone Joint Surg Am 86-A(Suppl 1):65–72

    PubMed  Google Scholar 

  10. Knutsen G, Engebretsen L, Ludvigsen TC, Drogset JO, Grontvedt T, Solheim E, Strand T, Roberts S, Isaksen V, Johansen O (2004) Autologous chondrocyte implantation compared with microfracture in the knee: a randomized trial. J Bone Joint Surg Am 86-A:455–464

    PubMed  Google Scholar 

  11. Lamb J, Murawski CD, Deyer TW, Kennedy JG (2013) Chevron-type medial malleolar osteotomy: a functional, radiographic and quantitative T2-mapping MRI analysis. Knee Surg Sports Traumatol Arthrosc 21:1283–1288

    Article  PubMed  Google Scholar 

  12. Lee GW, Son JH, Kim JD, Jung GH (2013) Is platelet-rich plasma able to enhance the results of arthroscopic microfracture in early osteoarthritis and cartilage lesion over 40 years of age? Eur J Orthop Surg Traumatol 23:581–587

    Article  PubMed  Google Scholar 

  13. Mei-Dan O, Carmont MR, Laver L, Mann G, Maffulli N, Nyska M (2012) Platelet-rich plasma or hyaluronate in the management of osteochondral lesions of the talus. Am J Sports Med 40:534–541

    Article  PubMed  Google Scholar 

  14. Roach R, McBride DJ, Maffulli N (2002) Osteochondral lesions of the talus. Minerva Ortop Traumatol 53:157–163

    Google Scholar 

  15. Robinson DE, Winson IG, Harries WJ, Kelly AJ (2003) Arthroscopic treatment of osteochondral lesions of the talus. J Bone Joint Surg Br 85:989–993

    Article  CAS  PubMed  Google Scholar 

  16. Sammartino G, Tia M, Gentile E, Marenzi G, Claudio PP (2009) Platelet-rich plasma and resorbable membrane for prevention of periodontal defects after deeply impacted lower third molar extraction. J Oral Maxillofac Surg 67:2369–2373

    Article  PubMed  Google Scholar 

  17. Sasaki K, Ishibashi Y, Sato H, Toh S (2003) Arthroscopically assisted osteochondral autogenous transplantation for osteochondral lesion of the talus using a transmalleolar approach. Arthroscopy 19:922–927

    Article  PubMed  Google Scholar 

  18. Schuman L, Struijs PA, van Dijk CN (2002) Arthroscopic treatment for osteochondral defects of the talus. Results at follow-up at 2 to 11 years. J Bone Joint Surg Br 84:364–368

    Article  CAS  PubMed  Google Scholar 

  19. Steadman JR, Rodkey WG, Briggs KK (2003) Microfracture chondroplasty: indications, techniques, and outcomes. Sports Med Arthrosc Rev 11:236–244

    Article  Google Scholar 

  20. Valderrabano V, Leumann A, Rasch H, Egelhof T, Hintermann B, Pagenstert G (2009) Knee-to-ankle mosaicplasty for the treatment of osteochondral lesions of the ankle joint. Am J Sports Med 37(Suppl 1):105S–111S

    Article  PubMed  Google Scholar 

  21. van Bergen CJ, Kerkhoffs GM, Ozdemir M, Korstjens CM, Everts V, van Ruijven LJ, van Dijk CN, Blankevoort L (2013) Demineralized bone matrix and platelet-rich plasma do not improve healing of osteochondral defects of the talus: an experimental goat study. Osteoarthritis Cartilage 21:1746–1754

    Article  PubMed  Google Scholar 

  22. Wakitani S, Kawaguchi A, Tokuhara Y, Takaoka K (2008) Present status of and future direction for articular cartilage repair. J Bone Miner Metab 26:115–122

    Article  PubMed  Google Scholar 

  23. Yol S, Tekin A, Yilmaz H, Kucukkartallar T, Esen H, Caglayan O, Tatkan Y (2008) Effects of platelet rich plasma on colonic anastomosis. J Surg Res 146:190–194

    Article  PubMed  Google Scholar 

  24. Zengerink M, Struijs PA, Tol JL, van Dijk CN (2010) Treatment of osteochondral lesions of the talus: a systematic review. Knee Surg Sports Traumatol Arthrosc 18:238–246

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Erciyes University Medical Faculty, Tepebaglar Cad. Bahcelievler Mah. Gulizar Konak, 7/49 Talas, 38280, Kayseri, Turkey

    Ahmet Guney, Ibrahim Karaman, Ibrahim Halil Kafadar & Mithat Oner

  2. Department of Orthopaedics and Traumatology, Osmaniye State Hospital, Osmaniye, Turkey

    Emre Yurdakul

  3. Department of Orthopaedics and Traumatology, Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey

    Okkes Bilal

Authors
  1. Ahmet Guney
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  2. Emre Yurdakul
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  3. Ibrahim Karaman
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  4. Okkes Bilal
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  5. Ibrahim Halil Kafadar
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  6. Mithat Oner
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Corresponding author

Correspondence to Ahmet Guney.

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None declared.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Guney, A., Yurdakul, E., Karaman, I. et al. Medium-term outcomes of mosaicplasty versus arthroscopic microfracture with or without platelet-rich plasma in the treatment of osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 24, 1293–1298 (2016). https://doi.org/10.1007/s00167-015-3834-y

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  • DOI: https://doi.org/10.1007/s00167-015-3834-y

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