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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 2, 179-183.
doi: 10.1302/0301-620X.87B2.15376  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Early results of autologous chondrocyte implantation in the talus

J.-P. Whittaker, MRCS, Specialist Registrar1; G. Smith, MRCS, Research Fellow1; N. Makwana, FRCS Orth, Consultant Orthopaedic Surgeon1; S. Roberts, PhD, Clinical Scientist1; P. E. Harrison, MMedSci, Clinical Scientist2; P. Laing, FRCS, Consultant Orthopaedic Surgeon1; and J. B. Richardson, MD, FRCS, Professor of Orthopaedics3

1 Centre for Spinal Studies
2 Arthritis Research Centre
3 Institute of Orthopaedics Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire SY10 7AG, UK.

Correspondence should be sent to Dr J. P. Whittaker at 99 Harwoods Lane, Rossett, Flintshire LL12 0EU, UK; e-mail: jpwhittaker{at}onetel.com

Autologous chondrocyte implantation (ACI) has been used most commonly as a treatment for cartilage defects in the knee and there are few studies of its use in other joints. We describe ten patients with an osteochondral lesion of the talus who underwent ACI using cartilage taken from the knee and were prospectively reviewed with a mean follow-up of 23 months. In nine patients the satisfaction score was ‘pleased’ or ‘extremely pleased’, which was sustained at four years. The mean Mazur ankle score increased by 23 points at a mean follow-up of 23 months. The Lysholm knee score returned to the pre-operative level at one year in three patients, with the remaining seven showing a reduction of 15% at 12 months, suggesting donor-site morbidity. Nine patients underwent arthroscopic examination at one year and all were shown to have filled defects and stable cartilage. Biopsies taken from graft sites showed mostly fibrocartilage with some hyaline cartilage. The short-term results of ACI for osteochondral lesions of the talus are good despite some morbidity at the donor site.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General