Document Detail

Osteochondral autograft transplantation for acute osteochondral fractures associated with an ankle fracture.
MedLine Citation:
PMID:  21733449     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Osteochondral fractures of the talar dome (OCFT) are frequently associated with ankle fractures. Controversy exists regarding the treatment of acute Grade III and IV OCFT. Osteochondral autograft transplantation (OAT) is a possible operative solution.
MATERIALS AND METHODS: We performed OAT in 16 patients with acute Grade III or IV OCFT. There were ten males and six females with the average age of 33.9 (range, 18 to 49) years. The average period of followup was 36.3 (range, 21 to 48) months. OCFT was identified, and clinically determined to be Grade III or IV using radiographs and intraoperative assessment. Seven patients were Grade III, nine patients were Grade IV OCFT. The OAT consisted of two sequential procedures: 1) harvesting of osteochondral autograft cylinder from the nonweightbearing surface of the ipsilateral knee, and 2) implanting the donor graft into the talar defect with press-fit technique. Single cylinder transplantation or a mosaicplasty was used. The outcome was determined by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, the simplified symptomatology evaluation, plain radiography and MRI.
RESULTS: The mean size of the osteochonral fracture defects was 84.1 (range, 50 to 125) mm(2), and the mean depth was 2.5 (range, 1 to 5) mm. The mean AOFAS score was 95.4 (range, 86 to 100) points postoperatively. At the latest followup, there was no radiographic evidence of post-traumatic arthritis. Based on the MRI of all patients, 93.7% of the osteochondral grafts showed bony integration and articular congruity of the talar dome.
CONCLUSION: OAT was shown to be an effective treatment with excellent clinical outcome and imaging evidence of graft integration.
Wanjun Liu; Fang Liu; Wen Zhao; Jaehon M Kim; Zhenghai Wang; Mark S Vrahas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Foot & ankle international     Volume:  32     ISSN:  1071-1007     ISO Abbreviation:  Foot Ankle Int     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-07-07     Completed Date:  2011-08-09     Revised Date:  2014-08-27    
Medline Journal Info:
Nlm Unique ID:  9433869     Medline TA:  Foot Ankle Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  437-42     Citation Subset:  IM    
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MeSH Terms
Ankle Injuries / radiography,  surgery*
Bone Transplantation*
Cartilage, Articular / radiography*
Follow-Up Studies
Fractures, Bone / radiography,  surgery*
Middle Aged
Talus / radiography,  surgery*
Transplantation, Autologous / methods
Treatment Outcome
Young Adult

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

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