Factors associated with the clinical outcomes of the osteochondral autograft transfer system in osteochondral lesions of the talus

Second-look arthroscopic evaluation

Yong Sang Kim, Eui Hyun Park, Yong Chan Kim, Yong Gon Koh, jinwoo lee

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: Identifying factors associated with the clinical outcomes of the osteochondral autograft transfer system would be helpful for treating patients with an osteochondral lesion of the talus. Purpose: To investigate the clinical and second-look arthroscopic results of the osteochondral autograft transfer system and to identify the prognostic factors associated with this procedure. Study Design: Case series; Level of evidence, 4. Methods: The authors retrospectively evaluated 52 ankles that underwent osteochondral autograft transfer for a medial osteochondral lesion of the talus. Second-look arthroscopies were performed at a mean of 13.1 months postoperatively. Clinical outcomes were evaluated according to a visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Tegner activity scale. Statistical analyses were performed to identify various prognostic factors associated with the clinical outcomes. Results: The mean VAS, AOFAS, and Tegner activity scale scores were all significantly improved from 6.9 6 0.9 to 3.3 6 1.4 (VAS), from 67.4±4.9 to 82.6±7.8 (AOFAS), and from 3.0±0.8 to 3.9±0.9 (Tegner; P<.05). Regarding overall patient satisfaction with the operation, 49 (95%) patients reported good to excellent results. Prognostic factors including the patients age, sex, body mass index, duration of symptoms, defect size and depth, location of osteochondral lesion of the talus, and the existence of a subchondral cyst did not significantly influence clinical outcomes (P <.05), except for body mass index on the Tegner activity scale score (P = .021). Significant differences were observed among clinical outcomes for second-look arthroscopy according to the presence of soft tissue impingement and uncovered areas around the graft (P>05). The VAS and AOFAS score at the last follow-up were significantly worse when the articular surface of the tibial plafond at the malleolar osteotomy site was uneven (P = .031 and .012, respectively). Conclusion: This study showed that the articular surface of the tibial plafond at the malleolar osteotomy site, soft tissue impingement, and uncovered areas around the graft were important factors affecting the clinical outcomes, as observed through secondlook arthroscopy. Therefore, surgeons should restore the articular surface accurately after the osteotomy, and more caution should be taken to avoid soft tissue impingement and uncovered areas around the graft when performing osteochondral autograft transfer.

Original languageEnglish
Pages (from-to)2709-2719
Number of pages11
JournalAmerican Journal of Sports Medicine
Volume40
Issue number12
DOIs
Publication statusPublished - 2012 Dec 1

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Talus
Autografts
Ankle
Orthopedics
Foot
Osteotomy
Visual Analog Scale
Joints
Arthroscopy
Transplants
Pain Measurement
Lysholm Knee Score

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

@article{c4c6557450bd4f0596b76a17e383c578,
title = "Factors associated with the clinical outcomes of the osteochondral autograft transfer system in osteochondral lesions of the talus: Second-look arthroscopic evaluation",
abstract = "Background: Identifying factors associated with the clinical outcomes of the osteochondral autograft transfer system would be helpful for treating patients with an osteochondral lesion of the talus. Purpose: To investigate the clinical and second-look arthroscopic results of the osteochondral autograft transfer system and to identify the prognostic factors associated with this procedure. Study Design: Case series; Level of evidence, 4. Methods: The authors retrospectively evaluated 52 ankles that underwent osteochondral autograft transfer for a medial osteochondral lesion of the talus. Second-look arthroscopies were performed at a mean of 13.1 months postoperatively. Clinical outcomes were evaluated according to a visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Tegner activity scale. Statistical analyses were performed to identify various prognostic factors associated with the clinical outcomes. Results: The mean VAS, AOFAS, and Tegner activity scale scores were all significantly improved from 6.9 6 0.9 to 3.3 6 1.4 (VAS), from 67.4±4.9 to 82.6±7.8 (AOFAS), and from 3.0±0.8 to 3.9±0.9 (Tegner; P<.05). Regarding overall patient satisfaction with the operation, 49 (95{\%}) patients reported good to excellent results. Prognostic factors including the patients age, sex, body mass index, duration of symptoms, defect size and depth, location of osteochondral lesion of the talus, and the existence of a subchondral cyst did not significantly influence clinical outcomes (P <.05), except for body mass index on the Tegner activity scale score (P = .021). Significant differences were observed among clinical outcomes for second-look arthroscopy according to the presence of soft tissue impingement and uncovered areas around the graft (P>05). The VAS and AOFAS score at the last follow-up were significantly worse when the articular surface of the tibial plafond at the malleolar osteotomy site was uneven (P = .031 and .012, respectively). Conclusion: This study showed that the articular surface of the tibial plafond at the malleolar osteotomy site, soft tissue impingement, and uncovered areas around the graft were important factors affecting the clinical outcomes, as observed through secondlook arthroscopy. Therefore, surgeons should restore the articular surface accurately after the osteotomy, and more caution should be taken to avoid soft tissue impingement and uncovered areas around the graft when performing osteochondral autograft transfer.",
author = "Kim, {Yong Sang} and Park, {Eui Hyun} and Kim, {Yong Chan} and Koh, {Yong Gon} and jinwoo lee",
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Factors associated with the clinical outcomes of the osteochondral autograft transfer system in osteochondral lesions of the talus : Second-look arthroscopic evaluation. / Kim, Yong Sang; Park, Eui Hyun; Kim, Yong Chan; Koh, Yong Gon; lee, jinwoo.

In: American Journal of Sports Medicine, Vol. 40, No. 12, 01.12.2012, p. 2709-2719.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors associated with the clinical outcomes of the osteochondral autograft transfer system in osteochondral lesions of the talus

T2 - Second-look arthroscopic evaluation

AU - Kim, Yong Sang

AU - Park, Eui Hyun

AU - Kim, Yong Chan

AU - Koh, Yong Gon

AU - lee, jinwoo

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Background: Identifying factors associated with the clinical outcomes of the osteochondral autograft transfer system would be helpful for treating patients with an osteochondral lesion of the talus. Purpose: To investigate the clinical and second-look arthroscopic results of the osteochondral autograft transfer system and to identify the prognostic factors associated with this procedure. Study Design: Case series; Level of evidence, 4. Methods: The authors retrospectively evaluated 52 ankles that underwent osteochondral autograft transfer for a medial osteochondral lesion of the talus. Second-look arthroscopies were performed at a mean of 13.1 months postoperatively. Clinical outcomes were evaluated according to a visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Tegner activity scale. Statistical analyses were performed to identify various prognostic factors associated with the clinical outcomes. Results: The mean VAS, AOFAS, and Tegner activity scale scores were all significantly improved from 6.9 6 0.9 to 3.3 6 1.4 (VAS), from 67.4±4.9 to 82.6±7.8 (AOFAS), and from 3.0±0.8 to 3.9±0.9 (Tegner; P<.05). Regarding overall patient satisfaction with the operation, 49 (95%) patients reported good to excellent results. Prognostic factors including the patients age, sex, body mass index, duration of symptoms, defect size and depth, location of osteochondral lesion of the talus, and the existence of a subchondral cyst did not significantly influence clinical outcomes (P <.05), except for body mass index on the Tegner activity scale score (P = .021). Significant differences were observed among clinical outcomes for second-look arthroscopy according to the presence of soft tissue impingement and uncovered areas around the graft (P>05). The VAS and AOFAS score at the last follow-up were significantly worse when the articular surface of the tibial plafond at the malleolar osteotomy site was uneven (P = .031 and .012, respectively). Conclusion: This study showed that the articular surface of the tibial plafond at the malleolar osteotomy site, soft tissue impingement, and uncovered areas around the graft were important factors affecting the clinical outcomes, as observed through secondlook arthroscopy. Therefore, surgeons should restore the articular surface accurately after the osteotomy, and more caution should be taken to avoid soft tissue impingement and uncovered areas around the graft when performing osteochondral autograft transfer.

AB - Background: Identifying factors associated with the clinical outcomes of the osteochondral autograft transfer system would be helpful for treating patients with an osteochondral lesion of the talus. Purpose: To investigate the clinical and second-look arthroscopic results of the osteochondral autograft transfer system and to identify the prognostic factors associated with this procedure. Study Design: Case series; Level of evidence, 4. Methods: The authors retrospectively evaluated 52 ankles that underwent osteochondral autograft transfer for a medial osteochondral lesion of the talus. Second-look arthroscopies were performed at a mean of 13.1 months postoperatively. Clinical outcomes were evaluated according to a visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Tegner activity scale. Statistical analyses were performed to identify various prognostic factors associated with the clinical outcomes. Results: The mean VAS, AOFAS, and Tegner activity scale scores were all significantly improved from 6.9 6 0.9 to 3.3 6 1.4 (VAS), from 67.4±4.9 to 82.6±7.8 (AOFAS), and from 3.0±0.8 to 3.9±0.9 (Tegner; P<.05). Regarding overall patient satisfaction with the operation, 49 (95%) patients reported good to excellent results. Prognostic factors including the patients age, sex, body mass index, duration of symptoms, defect size and depth, location of osteochondral lesion of the talus, and the existence of a subchondral cyst did not significantly influence clinical outcomes (P <.05), except for body mass index on the Tegner activity scale score (P = .021). Significant differences were observed among clinical outcomes for second-look arthroscopy according to the presence of soft tissue impingement and uncovered areas around the graft (P>05). The VAS and AOFAS score at the last follow-up were significantly worse when the articular surface of the tibial plafond at the malleolar osteotomy site was uneven (P = .031 and .012, respectively). Conclusion: This study showed that the articular surface of the tibial plafond at the malleolar osteotomy site, soft tissue impingement, and uncovered areas around the graft were important factors affecting the clinical outcomes, as observed through secondlook arthroscopy. Therefore, surgeons should restore the articular surface accurately after the osteotomy, and more caution should be taken to avoid soft tissue impingement and uncovered areas around the graft when performing osteochondral autograft transfer.

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