Abstract
A review of outcomes in 13 patients with talar dome osteochondral or chondral lesions
treated with a bone graft substitute plug was undertaken in an effort to evaluate
its effectiveness in comparison with other reported surgical techniques. Mean patient
age was 36.4 (range 16 to 57) years. Mean follow-up was 30.1 (range 7 to 43) months.
Medial malleolar osteotomy was performed in 9 (69.23%) cases. Average defect diameter
was 9.8 (range 5 to 20) mm. Pain decreased significantly from 6.2 (range 3 to 9) to
4.0 (range 0 to 9) (P = .009). Postoperative American Orthopaedic Foot and Ankle Society Ankle-Hindfoot
scores averaged 67.3 (range 26 to 100). Younger age, smaller defect size, and avoidance
of medial malleolar osteotomy resulted in better outcomes. Mean Short Form-36 scores
for the study group fell below US norms in all categories, and 12 (92.31%) ankles
demonstrated persistent lesions radiographically. Postoperative magnetic resonance
imaging in 2 (15.39%) patients demonstrated enlarged lesions, and 4 (30.77%) patients
underwent revision surgery that revealed abnormal cartilage around the implant site.
Complications included 1 (7.69%) deep venous thrombosis, 1 (7.69%) arthrofibrosis,
and 1 (7.69%) superficial neuritis. Despite some improvement in pain, comparison of
functional outcome showed bone graft substitute plug implantation to be less effective
overall than other operative interventions. Future investigations with more specific
selection criteria are warranted to gain further insight into the efficacy of these
bone graft substitute plugs.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: April 01, 2010
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
