323 334

Cited 0 times in

Factors associated with the clinical outcomes of the osteochondral autograft transfer system in osteochondral lesions of the talus: second-look arthroscopic evaluation

Authors
 Yong Sang Kim  ;  Eui Hyun Park  ;  Yong Chan Kim  ;  Yong Gon Koh  ;  Jin Woo Lee 
Citation
 AMERICAN JOURNAL OF SPORTS MEDICINE, Vol.40(12) : 2709-2719, 2012 
Journal Title
AMERICAN JOURNAL OF SPORTS MEDICINE
ISSN
 0363-5465 
Issue Date
2012
MeSH
Adult ; Aged ; Ankle Injuries/diagnosis ; Ankle Injuries/surgery* ; Arthroscopy* ; Bone Transplantation* ; Cartilage/transplantation* ; Female ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Prognosis ; Retrospective Studies ; Second-Look Surgery ; Talus/injuries* ; Transplantation ; Autologous ; Young Adult
Keywords
osteochondral autograft transfer system ; osteochondral lesions ; talus ; second-look arthroscopy
Abstract
BACKGROUND: Identifying factors associated with the clinical outcomes of the osteochondral autograft transfer system would be helpful for treating patients with an osteochondral lesion of the talus.

PURPOSE: To investigate the clinical and second-look arthroscopic results of the osteochondral autograft transfer system and to identify the prognostic factors associated with this procedure.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: The authors retrospectively evaluated 52 ankles that underwent osteochondral autograft transfer for a medial osteochondral lesion of the talus. Second-look arthroscopies were performed at a mean of 13.1 months postoperatively. Clinical outcomes were evaluated according to a visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Tegner activity scale. Statistical analyses were performed to identify various prognostic factors associated with the clinical outcomes.

RESULTS: The mean VAS, AOFAS, and Tegner activity scale scores were all significantly improved from 6.9 ± 0.9 to 3.3 ± 1.4 (VAS), from 67.4 ± 4.9 to 82.6 ± 7.8 (AOFAS), and from 3.0 ± 0.8 to 3.9 ± 0.9 (Tegner; P < .05). Regarding overall patient satisfaction with the operation, 49 (95%) patients reported good to excellent results. Prognostic factors including the patient's age, sex, body mass index, duration of symptoms, defect size and depth, location of osteochondral lesion of the talus, and the existence of a subchondral cyst did not significantly influence clinical outcomes (P > .05), except for body mass index on the Tegner activity scale score (P = .021). Significant differences were observed among clinical outcomes for second-look arthroscopy according to the presence of soft tissue impingement and uncovered areas around the graft (P < .05). The VAS and AOFAS score at the last follow-up were significantly worse when the articular surface of the tibial plafond at the malleolar osteotomy site was uneven (P = .031 and .012, respectively).

CONCLUSION: This study showed that the articular surface of the tibial plafond at the malleolar osteotomy site, soft tissue impingement, and uncovered areas around the graft were important factors affecting the clinical outcomes, as observed through second-look arthroscopy. Therefore, surgeons should restore the articular surface accurately after the osteotomy, and more caution should be taken to avoid soft tissue impingement and uncovered areas around the graft when performing osteochondral autograft transfer.
Files in This Item:
T201203950.pdf Download
DOI
23097298
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Sang(김용상)
Lee, Jin Woo(이진우) ORCID logo https://orcid.org/0000-0002-0293-9017
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89457
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links