Document Detail


Effectiveness of composite bone graft substitute plugs in the treatment of chondral and osteochondral lesions of the talus.
MedLine Citation:
PMID:  20356769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A review of outcomes in 13 patients with talar dome osteochondral or chondral lesions treated with a bone graft substitute plug was undertaken in an effort to evaluate its effectiveness in comparison with other reported surgical techniques. Mean patient age was 36.4 (range 16 to 57) years. Mean follow-up was 30.1 (range 7 to 43) months. Medial malleolar osteotomy was performed in 9 (69.23%) cases. Average defect diameter was 9.8 (range 5 to 20) mm. Pain decreased significantly from 6.2 (range 3 to 9) to 4.0 (range 0 to 9) (P = .009). Postoperative American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scores averaged 67.3 (range 26 to 100). Younger age, smaller defect size, and avoidance of medial malleolar osteotomy resulted in better outcomes. Mean Short Form-36 scores for the study group fell below US norms in all categories, and 12 (92.31%) ankles demonstrated persistent lesions radiographically. Postoperative magnetic resonance imaging in 2 (15.39%) patients demonstrated enlarged lesions, and 4 (30.77%) patients underwent revision surgery that revealed abnormal cartilage around the implant site. Complications included 1 (7.69%) deep venous thrombosis, 1 (7.69%) arthrofibrosis, and 1 (7.69%) superficial neuritis. Despite some improvement in pain, comparison of functional outcome showed bone graft substitute plug implantation to be less effective overall than other operative interventions. Future investigations with more specific selection criteria are warranted to gain further insight into the efficacy of these bone graft substitute plugs.
Authors:
Jason S Lin; Lucille B Andersen; Paul J Juliano
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-31
Journal Detail:
Title:  The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons     Volume:  49     ISSN:  1542-2224     ISO Abbreviation:  J Foot Ankle Surg     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-07-07     Completed Date:  2010-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9308427     Medline TA:  J Foot Ankle Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  224-31     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
The Institute for Foot and Ankle Reconstruction at Mercy Medical Center, Baltimore, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Ankle Injuries / diagnosis,  surgery
Ankle Joint / pathology,  radiography,  surgery*
Arthroscopy / methods
Bone Substitutes*
Bone Transplantation / methods*
Cartilage, Articular / injuries,  surgery
Chi-Square Distribution
Cohort Studies
Female
Follow-Up Studies
Graft Survival
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Osteochondritis / diagnosis,  surgery
Osteotomy / methods*
Range of Motion, Articular / physiology
Recovery of Function
Retrospective Studies
Risk Assessment
Talus / injuries,  radiography,  surgery*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Bone Substitutes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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