According to study results, autologous osteochondral transplantation for management of large osteochondral talar defects was a viable option for athletes and led to satisfactory return to sport levels, patient satisfaction scores and pain scores.
Researchers assessed 38 athletes with a talar osteochondral lesion of 150 mm2 or greater. All patients underwent autologous osteochondral transplantation from the lateral femoral condyle and mean lesion size was 249 mm2. At 12 months postoperatively, the MR observation of cartilage repair tissue (MOCART) score was used to assess graft incorporation. Investigators assessed patients’ return to sport, VAS and foot and ankle outcome scores at 24 months. Mean follow-up was 45 months.
Results showed 33 patients were able to return to their previous level of sport, four athletes returned at a lower level of sport vs. their preinjury level and one athlete was not able to return to sport. Investigators noted the mean return to play was 8.2 months. From preoperatively to postoperatively, the VAS score improved from 4.53 to 0.63. The foot and ankle outcome score significantly improved in all domains. There were two patients who developed pain at the knee donor site, which had three osteochondral plugs harvested.
According to univariate analysis results, there was no correlation between preoperative patient and lesion characteristics and return to sport, whereas there was a significant correlation between the MOCART score and return to sport. The area under receiver operating characteristic was 0.891 for the MOCART score and return to play. The MOCART score was 52.50, which researchers wrote demonstrated a sensitivity of 0.85 and a specificity of 0.80 for the determination of an athlete’s ability to return to their previous level of activity. – by Monica Jaramillo
Disclosure s : The researchers report no relevant financial disclosures.