Synthetic bone grafting with preserved cartilage flap via a medial malleolus osteotomy approach to treat osteochondral lesion of the talus: technical note and preliminary clinical results

作者全名："Yao, Xudong; Yun, Zhu; Du, Yu; Xie, Xiaowei; Chen, Shirong; Cheng, Xiangjun"

作者地址："[Yao, Xudong; Xie, Xiaowei; Chen, Shirong; Cheng, Xiangjun] Chongqing Med Univ, Affiliated Hosp 2, Ctr Joint Surg, Dept Orthoped Surg, Chongqing, Peoples R China; [Yun, Zhu] Chongqing Med Univ, Affiliated Hosp 2, Emergency Dept, Chongqing, Peoples R China; [Du, Yu] Chongqing Med Univ, Affiliated Hosp 2, Dept Orthoped Surg, Chongqing, Peoples R China"

通信作者："Cheng, XJ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Ctr Joint Surg, Dept Orthoped Surg, Chongqing, Peoples R China."

来源：INTERNATIONAL ORTHOPAEDICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001044199400001

JCR分区：Q2

影响因子：2

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Osteochondral lesion of the talus; Cartilage flap; Malleolus osteotomy; Synthetic bone grafting

摘要："PurposeAlthough various surgical procedures are available for osteochondral lesion of the talus (OLT), there is still no consensus on its best treatment. The purposes of this study were to describe a new surgical technique to treat OLT and to analyze its preliminary clinical results.MethodsEight patients were enrolled in this retrospective study between March 2019 and May 2022 in the Second Affiliated Hospital of Chongqing Medical University. All patients were treated by synthetic bone grafting with preserved cartilage flap via a medial malleolus osteotomy approach. The patients' characteristics, operative time, and estimated blood loss were evaluated. Intraoperative photos, preoperative and postoperative X-ray and MRI imaging were recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analog scale (VAS) score were also recorded before surgery and at each follow-up.ResultsAt six months after the operation, all patients showed bone ingrowth and remodeling according to X-ray and MRI. No obvious defects or ladder was found on the cartilage surface of all patients according to MRI. The AOFAS score improved from 61.63 & PLUSMN; 8.85 (range, 49-74) to 91.13 & PLUSMN; 4.49 (range, 83-97) (p < 0.001) and VAS score improved from 5.50 & PLUSMN; 1.60 (range, 4-8) before surgery to 1.88 & PLUSMN; 0.83 (range, 1-3) (p < 0.001) at latest follow-up. In all eight patients, no wound infection, skin necrosis, or delayed healing of osteotomy was found.ConclusionWe proposed a simple and effective technique that restored the shape of the cartilage surface by preserving the cartilage flap and restoring the natural congruency of the subchondral bone by synthetic bone grafting. We found satisfying clinical outcomes in short-term follow-up. Our new technique might be a new surgical option for the treatment of OLT and its effectiveness should be further evaluated."

基金机构：Medical Technology Innovation Project of The Second Affiliated Hospital of Chongqing Medical University

基金资助正文：This research was supported by Medical Technology Innovation Project of The Second Affiliated Hospital of Chongqing Medical University.