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Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation ± Calcaneal Autograft: A Cohort Study
Journal article   Peer reviewed

Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation ± Calcaneal Autograft: A Cohort Study

Joseph E Manzi, Kshitij Manchanda, Matthew H Nasra, Suleiman Y Sudah, Carlo Coladonato, Theodore Quan, Mark Wishman, Jay Moran, Daniel P Murray and Cary B Chapman
European journal of orthopaedic surgery & traumatology, v 34(1), pp 561-568
01 Jan 2024
DOI: https://doi.org/10.1007/s00590-023-03642-7
PMID: 37650974

Abstract

Allografts Autografts Bone Transplantation Cartilage, Articular - injuries Cartilage, Articular - surgery Cohort Studies Humans Retrospective Studies Talus - surgery Treatment Outcome
Osteochondral lesions of the talus (OCLT) are common injuries that can be difficult to treat. To date, long-term patient reported outcome measures (PROMs) of patients with particulated juvenile allograft cartilage implantation with or without calcaneal autograft have not been compared. Thirteen patients with difficult to treat OCLTs underwent arthroscopic-assisted implantation of particulated juvenile allograft cartilage (DeNovo NT®) with or without autogenous calcaneal bone grafting by a single surgeon. Calcaneal bone graft use was determined by lesion size > 150 mm and/or deeper than 5 mm. Patients were evaluated using physical examination, patient interviews, and PROMs. When comparing patients in regards to calcaneal bone graft implantation, no difference in age, BMI, pre-operative PROMs, or follow-up was noted, however, calcaneal bone graft patients did have a significantly larger lesion size (188.5 ± 50.9 vs. 118.7 ± 29.4 mm respectively; p value = 0.027). VAS and FAAM ADL scores during final follow-up improvement did not significantly differ between cohorts. The FAAM Sports score improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.032). The AOFAS score improvement did not differ between cohorts (p value = 0.944), however, the SF-36 PCS improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.038). No intraoperative/perioperative complications were observed with calcaneal bone grafting. While patients followed over the course of ~ 8 years after implantation of particulated juvenile allograft cartilage (DeNovo NT®) with/without autogenous calcaneal bone graft had positive post-operative PROMs, patients without calcaneal bone graft had significantly greater improvement in functional outcome scores. Whether these differences are due to graft incorporation or larger lesion size is unclear. III, retrospective cohort study.

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Domestic collaboration
Web of Science research areas
Orthopedics
Surgery
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