Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus
Abstract Background Osteochondral lesions of the talus (OLTs) with a large subchondral cyst have been shown to have inferior clinical outcomes after reparative techniques. Replacement techniques such as autologous osteoperiosteal transplantation (AOPT) and autologous osteochondral transplantation (A...
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SpringerOpen
2025-02-01
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| Series: | Journal of Orthopaedics and Traumatology |
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| Online Access: | https://doi.org/10.1186/s10195-025-00818-1 |
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| author | Lequan Liu Jiangtao Jin Jinping Pan Huikang Guo Sen Li Jisheng Li Zheng Zhang |
| author_facet | Lequan Liu Jiangtao Jin Jinping Pan Huikang Guo Sen Li Jisheng Li Zheng Zhang |
| author_sort | Lequan Liu |
| collection | DOAJ |
| description | Abstract Background Osteochondral lesions of the talus (OLTs) with a large subchondral cyst have been shown to have inferior clinical outcomes after reparative techniques. Replacement techniques such as autologous osteoperiosteal transplantation (AOPT) and autologous osteochondral transplantation (AOCT) are indicated for large lesions. The aim of the study was to compare the short-term clinical and radiographic outcomes between patients undergoing AOPT and those undergoing AOCT for large cystic OLTs. Methods Patients who underwent AOPT or AOCT for medial large cystic OLTs between May 2019 and June 2023 were retrospectively evaluated. According to their characteristics, 1:1 propensity‐score matching was performed, and 65 pairs of patients with ages ranging from 18 to 60 years old were recruited. Clinical outcomes were compared between both groups with the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS). The Ankle Activity Score (AAS), time to return to sports activity (RTA), rate of return to sports level, complications, and results of a subjective evaluation were also collected. The integrity of subchondral bone and the quality of repaired cartilage were evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score 12 months postoperatively. Second-look arthroscopy was performed 12 months postoperatively, and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society (ICRS). Results The within-group comparison showed significant improvements in pain severity and function in both groups post-treatment compared with pre-treatment. Between-group analysis, however, showed no significant statistical difference between groups in any of the variables for clinical and radiographic outcomes, except for donor-site morbidity of the AOPT group, which showed a better outcome compared to the AOCT group. Conclusions In the treatment of large cystic OLTs, for patients with a chondral lesion of the patellofemoral joint that is unsuitable for AOCT, AOPT may be a safe and effective choice, with lower donor-site morbidity of the normal knee joint. |
| format | Article |
| id | doaj-art-4d5e9b870a0e40d7926bb3bc68aa5bd2 |
| institution | Kabale University |
| issn | 1590-9999 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj-art-4d5e9b870a0e40d7926bb3bc68aa5bd22025-02-09T12:49:45ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992025-02-012611810.1186/s10195-025-00818-1Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talusLequan Liu0Jiangtao Jin1Jinping Pan2Huikang Guo3Sen Li4Jisheng Li5Zheng Zhang6Arthroplasty Dept, Jincheng General HospitalArthroplasty Dept, Jincheng General HospitalArthroplasty Dept, Jincheng General HospitalArthroplasty Dept, Jincheng General HospitalArthroplasty Dept, Jincheng General HospitalArthroplasty Dept, Jincheng General HospitalArthroplasty Dept, Jincheng General HospitalAbstract Background Osteochondral lesions of the talus (OLTs) with a large subchondral cyst have been shown to have inferior clinical outcomes after reparative techniques. Replacement techniques such as autologous osteoperiosteal transplantation (AOPT) and autologous osteochondral transplantation (AOCT) are indicated for large lesions. The aim of the study was to compare the short-term clinical and radiographic outcomes between patients undergoing AOPT and those undergoing AOCT for large cystic OLTs. Methods Patients who underwent AOPT or AOCT for medial large cystic OLTs between May 2019 and June 2023 were retrospectively evaluated. According to their characteristics, 1:1 propensity‐score matching was performed, and 65 pairs of patients with ages ranging from 18 to 60 years old were recruited. Clinical outcomes were compared between both groups with the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS). The Ankle Activity Score (AAS), time to return to sports activity (RTA), rate of return to sports level, complications, and results of a subjective evaluation were also collected. The integrity of subchondral bone and the quality of repaired cartilage were evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score 12 months postoperatively. Second-look arthroscopy was performed 12 months postoperatively, and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society (ICRS). Results The within-group comparison showed significant improvements in pain severity and function in both groups post-treatment compared with pre-treatment. Between-group analysis, however, showed no significant statistical difference between groups in any of the variables for clinical and radiographic outcomes, except for donor-site morbidity of the AOPT group, which showed a better outcome compared to the AOCT group. Conclusions In the treatment of large cystic OLTs, for patients with a chondral lesion of the patellofemoral joint that is unsuitable for AOCT, AOPT may be a safe and effective choice, with lower donor-site morbidity of the normal knee joint.https://doi.org/10.1186/s10195-025-00818-1Osteochondral lesionTalusOsteoperiostealTransplantation |
| spellingShingle | Lequan Liu Jiangtao Jin Jinping Pan Huikang Guo Sen Li Jisheng Li Zheng Zhang Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus Journal of Orthopaedics and Traumatology Osteochondral lesion Talus Osteoperiosteal Transplantation |
| title | Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus |
| title_full | Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus |
| title_fullStr | Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus |
| title_full_unstemmed | Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus |
| title_short | Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus |
| title_sort | osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus |
| topic | Osteochondral lesion Talus Osteoperiosteal Transplantation |
| url | https://doi.org/10.1186/s10195-025-00818-1 |
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