Outcomes of talar dome osteochondral defect repair using osteocartilaginous autografts: 37 cases of Mosaicplasty(R).
Fiche publication
Date publication
février 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MAINARD Didier
Tous les auteurs :
de l'Escalopier N, Barbier O, Mainard D, Mayer J, Ollat D, Versier G
Lien Pubmed
Résumé
BACKGROUND: The indications of osteochondral autograft implantation using the Mosaicplasty((R)) technique were only recently extended to osteochondral lesions of the talus (OLT), a site for which no medium- or long-term outcome data are available. Our objective here was to evaluate medium-term outcomes in case-series of patients who underwent Mosaicplasty((R)) for OLT repair. HYPOTHESIS: Mosaicplasty((R)) provides good medium-term outcomes with low morbidity when used for OLT repair. PATIENTS ET METHODS: We retrospectively reviewed cases of Mosaicplasty((R)) for OLT repair, performed in combination with malleolar osteotomy on the side of the OLT, at either of two centres, between 1997 and 2013. Pre-operative clinical data were collected from the medical records and all patients were re-evaluated. We studied 37 patients with a mean age of 33 years. RESULTS: Mean follow-up at re-evaluation was 76 months. Mean AOFAS score at re-evaluation was 83 (range, 9-100). A work-related cause to the OLT was associated with significantly poorer outcomes (P=0.01). AOFAS values were significantly better in patients whose OLT size was 0.5 to 1cm(2). The Ogilvie-Harris score at last follow-up was good or excellent in 78% of patients. No patient experienced morbidity related to the malleolar osteotomy. Persistent patellar syndrome was noted in 6 patients. DISCUSSION: In our case-series, Mosaicplasty((R)) for OLT repair provided good medium-term outcomes in 78% of patients. Nevertheless, the donor-site morbidity should be borne in mind. Mosaicplasty((R)) deserves to be viewed as a reference standard method for OLT repair. LEVEL OF EVIDENCE: IV, retrospective study.
Référence
Orthop Traumatol Surg Res. 2015 Feb;101(1):97-102