Why Allograft Reconstruction for Osteochondral Lesion of the Talus? The Osteochondral Autograft Transfer System Seemed to Work Quite Well

2013 ◽  
Vol 18 (1) ◽  
pp. 89-112 ◽  
Author(s):  
Anish R. Kadakia ◽  
Norman Espinosa
2017 ◽  
Vol 107 (6) ◽  
pp. 541-547 ◽  
Author(s):  
Nobuaki Chinzei ◽  
Noriyuki Kanzaki ◽  
Takaaki Fujishiro ◽  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
...  

Simple bone cysts compose approximately 3% of all primary bone tumors and most commonly occur in the metaphyseal regions of the proximal humerus and femur. The percentage of the talus with suspected bone tumors is reported to be 0.003%. Therefore, talar cysts are rare but sometimes present as aggressive lesions, and they can affect any of the tarsal bones. Recently, an arthroscopic approach to these lesions has been developed that is less invasive than conventional open surgery. In the present case study, we profile a 65-year-old female patient who received arthroscopic debridement of a bone cyst from the medial aspect of the talus with the osteochondral autograft transfer system (OATS). By using the OATS core harvester, we penetrated into the tumor. After the cylindrical bone plug was pulled out, the tumor was removed and artificial bone granules were firmly packed into the cavity with intralesional arthroscopy. Then, the cylindrical bone plug previously harvested by OATS was implanted at the site with careful precision. This intervention resulted in a relative restoration of talar dome anatomy and ultimately restored the patient to activity with minimal discomfort. Therefore, arthroscopic debridement with OATS has the potential to be a useful option in dealing with debilitating osteochondral cystic lesions.


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0044
Author(s):  
Dong Woo Shim ◽  
Yeokgu Hwang ◽  
Kwang Hwan Park ◽  
Jin Woo Lee ◽  
Seung Hwan Han

Category: Ankle Introduction/Purpose: Osteochondral lesions of talus (OLTs) are often treated primarily by fragment excision, abrasion, drilling, or microfracture. However, OLT accompanying with large cyst has been challenged to yield good outcome nevertheless of many surgical options. Recent study showed significant high failure rate of arthroscopic marrow stimulation treatment larger than 150mm2. The current study is to investigate the outcome of the primary osteochondral autograft transfer system (OATS) for large cystic type OLT (>150mm2). Methods: This retrospective analysis included 19 talus (19 patients) with diagnosed large cystic type OLT (>150mm2) who received primary OATS between September 2009 and March 2013. Defect size area was measured on magnetic resonance imaging (MRI) by the ellipse formula from coronal and sagittal length. The patients completed the visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society (AOFAS) score preoperatively and at follow-up. Plain radiographs were used to show the improvement of radiolucency postoperatively. Results: The mean follow up period was 83.9 months (57 – 99) and the average defect size area was 169.4 mm2 (151.3 – 392.6). The Mean VAS score decreased from 6.95 preoperatively to 2.6 postoperatively. Average AOFAS score improved from 66.8 preoperatively to 88.7 postoperatively. Eighty percent of patients rated their result excellent or good. The radiolucent area of the cysts disappeared on the plain radiographs in all cases. Conclusion: Long-term clinical results of primary OATS in large cystic type OLT showed good outcomes and patients could significantly benefit from this surgery.


2007 ◽  
Vol 28 (11) ◽  
pp. 1200-1203 ◽  
Author(s):  
Dominic S. Carreira ◽  
Pierce E. Scranton Jr

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