Particulated Juvenile Articular Cartilage Allograft Transplantation for Osteochondral Talar Lesions.

OBJECTIVE

To report on our institution's early results from juvenile particulate cartilage allograft transplantation of the talus.

DESIGN

Because of the relative rarity of the procedure at the talus, it was decided to provide a comprehensive understanding of the currently available evidence via a 2-part study with (1) a systematic review of the literature and (2) a retrospective single-center cohort study of the authors' patients, their demographics, and their early outcomes.

RESULTS

(1) Four studies were included with 33 ankles with a weighted mean follow-up of 14.3 months. Only 1 ankle (3.3%) was converted to a revision open osteochondral allograft with medial malleolar osteotomy at 16 months postoperative; 6 (18.2%) required nonrevision type reoperations at an average of 15 months postoperative. (2) Six patients with mean age 35.7 ± 14.4 years were evaluated from the authors' institution at mean 13.04 ± 8.35 months' follow-up. All reported subjective improvements in pain and motion, and functional improvements, although postoperative magnetic resonance imaging in 3 patients at time points between 3 months and 2 years postoperative demonstrate persistent subchondral edema and nonuniform chondral surface in the talus. There were no intraoperative or postoperative complications, and there have been no reoperations.

CONCLUSION

Preliminary data suggest that treatment of large, traumatic or atraumatic, symptomatic osteochondral talar defects with particulated juvenile cartilage transplantation may improve patient subjective complaints of pain and function. Systematic review of the available literature highlights the need for future prospective, larger cohort studies of its use on the talus but suggests similar potential for the technology.