Treatment of osteochondral lesions in the ankle with a particulated juvenile cartilage allograft: Four-year outcomes

Aida Sarcon, Christopher Kreulen, J Chris Coetzee, Steven Neufeld, Gregory Berlet, Thomas Dowd, Paul Ryan, Justin Robbins, Robert Neher, Karim Boukhemis, Lew Schon, Eric Giza

Abstract


AIM: reports mid-term clinical outcomes after treating osteochondral lesions of the talus with a particulated juvenile cartilage allograft or cartilage-allograft.

MATERIALS AND METHODS: multicenter prospective case series. Lesions were treated with cartilage-allograft. Primary outcomes were pain, function, and activity levels. Clinical outcomes for 24 prospective subjects over 4-years are presented. The overall clinical outcomes were analyzed using repeated measures models

RESULTS: There was significant pre to postoperative improvement in the overall pain, Short-form 12 Health survey physical, Foot and Ankle Ability Measure activities of daily living, and Foot and Ankle Ability Measure sport (n=22) scores at 12, 24, 36, and 48-months (P<.05). There were no significant pre to postoperative changes in the overall Short-form mental health scores (P>.05).  Lesions less than 150mm² predominantly achieved significant pre to postoperative improvement in scores over 48-months. Except for the sport scores at select visits, there were no differences in outcomes among postoperative visits(P>.05). When the variables of lesion sizes, operative technique, and prior ankle operation were compared, repeated measures did not reveal any differences between these variables in effect on outcomes.

CONCLUSION: Four-year outcomes suggest that treatment with a cartilage-allograft led to improved function and pain levels without symptom worsening, and it is an effective operative intervention for symptomatic lesions irrespective of lesion size.


Keywords


Osteochondral lesions, talus, particulated juvenile cartilage allograft, biologics

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