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Treatment of Osteochondral Defects in the Rabbit's Knee Joint by Implantation of Allogeneic Mesenchymal Stem Cells in Fibrin Clots
Published on: May 21, 2013
Autologous bone graft and periosteal patch for large and recurrent talar osteochondral defect: A prospective study
Ali M Safaan1, Y A Radwan1, Ahmed Khedr1
1Orthopaedic Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Background:
Osteochondral injuries of the talus (OLT) are common as a variety of mechanisms causes them. Asymptomatic presentation with an underlying damaged bone and the overlapping symptoms with a simple sprain make OLT a potentially career-ending injury. The best surgical intervention aims to alleviate pain and improve long-term outcomes as well. These outcomes can be measured by 3 major clinical measurements: Visual analogue Score (VAS), American Orthopedic Foot and Ankle Society (AOFAS), and Foot and Ankle Disability Index (FADI), in addition to achieving the lowest complication rate possible. In this prospective study, we aim to evaluate the functional outcome of the treatment of large and recurrent OLT by osteoperiosteal patch.
Methods:
Thirty patients with large (>1.5 cm2) or recurrent OLTs were prospectively treated using an osteoperiosteal graft. The procedure involved medial malleolar osteotomy, curettage of the lesion, followed by autologous cancellous bone grafting from the distal tibia, and periosteal transfer to cover the defect.
Results:
VAS pain scores significantly decreased from a preoperative mean of 7.07 to 0.43 at the last follow-up. FADI scores significantly increased from 53.77 preoperatively to 93.8 at the last follow-up, indicating improved functional abilities. AOFAS scores also significantly increased from 40.6 preoperatively to 95.13 at the last follow-up, reflecting improvements in overall clinical status. The complication rate was low, with a few cases of superficial infection, DVT, and pain at the screw site, but no major complications related to the donor site.
Conclusion:
The osteoperiosteal graft technique is a safe and effective method for treating large and recurrent OLTs. This single-stage procedure offers significant improvements in pain, functional abilities, and overall clinical status, with results that align with other similar studies, while also avoiding donor site complications and disease transmission risks.
