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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 5, 614-619.
doi: 10.1302/0301-620X.88B5.17306  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions of the talus

P. E. Scranton, Jr, MD, Orthopaedic Surgeon1; C. C. Frey, MD, Orthopaedic Surgeon2; and K. S. Feder, MD, Orthopaedic Surgeon2

1 Orthopaedics International Ltd, 12333 NE 130th Lane, Suite 400, Kirkland, WA 98034, USA.
2 1200 Rosecrans Ave, #208 Manhatten Beach, California 90266-2470, USA.

Correspondence should be sent to Dr P. E. Scranton at 12333 NE 130th Lane, Suite 400, Kirkland,Washington 98034, USA; e-mail: piercescranton{at}hotmail.com

The treatment of osteochondral lesions of the talus has evolved with the development of improved imaging and arthroscopic techniques. However, the outcome of treatment for large cystic type-V lesions is poor, using conventional grafting, debridement or microfracture techniques.

This retrospective study examined the outcomes of 50 patients with a cystic talar defect who were treated with arthroscopically harvested, cored osteochondral graft taken from the ipsilateral knee.

Of the 50 patients, 45 (90%) had a mean good to excellent score of 80.3 (52 to 90) in the Karlsson-Peterson Ankle Score, at a mean follow-up of 36 months (24 to 83). A malleolar osteotomy for exposure was needed in 26 patients and there were no malleolar mal- or nonunions. One patient had symptoms at the donor site three months after surgery; these resolved after arthroscopic release of scar tissue.

This technique is demanding with or without a malleolar osteotomy, but if properly performed has a high likelihood of success.






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