Department of Orthopedic Surgery, Tianjin First Central Hospital, Tianjin, 300192, China.
Department of Hand and Foot Surgery, The Affiliated Hospital of Qingdao University, 1677, Wutaishan Road, Huang Dao Area, Qing Dao City, Shan Dong Province, 266000, China.
Int Orthop. 2022 Jul;46(7):1547-1555. doi: 10.1007/s00264-022-05380-7. Epub 2022 Mar 25.
There are few studies on the clinical outcomes of osteochondral autologous transplantation (OAT) harvesting from local talar non-weight-bearing articular facets for the treatment of osteochondral lesions of the talus (OLTs). The purpose of this study was to review the short- to midterm outcomes of our patients who were treated with OAT harvesting from ipsilateral talar articular facets for OLTs.
Between December 2010 and November 2018, 24 patients were enrolled in this study. There were 16 males and eight females with an average age of 39.1 years and a follow-up period of 50.9 months. The clinical results were evaluated according to the American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS) score. Pre-operative plain radiographs and magnetic resonance imaging (MRI) scans, post-operative radiographs, and X-ray and computed tomography (CT) scans at the last follow-up were observed.
There was a significant improvement in the AOFAS score from 61.3 ± 19.0 pre-operatively to 84.9 ± 9.2 post-operatively (P < 0.001). The VAS score improved from 6.1 ± 2.3 to 2.0 ± 1.4 at the last follow-up (P < 0.001). Twenty-one patients (87.5%) were satisfied with their clinical results. By the last follow-up CT scan, there was bone cyst formation at the donor sites in three patients, at the recipient sites in five patients and at both sites in five patients. Two patients (8.3%) underwent re-operation with arthroscopic debridement because of medial gutter hypertrophic soft tissue impingement.
OAT harvesting from the ipsilateral talar articular facet showed satisfactory results. The mean post-operative VAS score and AOFAS ankle-hindfoot score improved significantly. Post-operative impingement around the osteotomy site was the main complication and reason for re-operation after the index procedure. In addition, bone cysts at the recipient and/or donor site(s) were found with a large percentage under CT. Therefore, longer follow-up is necessary to determine the long-term clinical results for this technique.
对于距骨骨软骨病变（OLT）的治疗，目前仅有少数研究关注从局部距骨非负重关节面进行自体骨软骨移植（OAT）的临床结果。本研究旨在回顾采用同侧距骨关节面采集 OAT 治疗 OLT 患者的短期至中期结果。
2010 年 12 月至 2018 年 11 月，共纳入 24 例患者，其中男 16 例，女 8 例，平均年龄 39.1 岁，随访时间 50.9 个月。采用美国矫形足踝协会（AOFAS）踝-后足评分和视觉模拟评分（VAS）评估临床结果。观察术前平片、磁共振成像（MRI）扫描、术后 X 线片和最后一次随访时的 X 线和计算机断层扫描（CT）。
AOFAS 评分从术前的 61.3±19.0 显著改善至术后的 84.9±9.2（P<0.001），VAS 评分从术前的 6.1±2.3 改善至末次随访时的 2.0±1.4（P<0.001）。21 例（87.5%）患者对临床结果满意。末次随访时 CT 扫描显示，3 例供区、5 例受区及 5 例供受区均出现骨囊肿形成。2 例（8.3%）患者因内侧隐窝肥厚性软组织撞击行关节镜下清理术。
同侧距骨关节面采集 OAT 效果满意，术后平均 VAS 评分和 AOFAS 踝-后足评分显著改善。术后截骨部位周围撞击是主要并发症，也是索引手术后再次手术的主要原因。此外，CT 发现大量受区和/或供区（s）存在骨囊肿。因此，需要更长时间的随访来确定该技术的长期临床效果。
