Abstract
Autologous osteochondral transplantation (AOT) is used in the treatment of osteochondral
lesions (OCL) of the talus. The purpose of this study was to compare the differences
in the presentation of talar OCLs and outcomes following AOT between male and female
patients. Eighty-seven consecutive patients, ages 16 to 65 years, who underwent AOT
were retrospectively reviewed. Patients were divided into 2 groups based on sex. Demographic
data and OCL defect characteristic data were recorded. Functional outcomes were assessed
pre- and postoperatively using the Foot and Ankle Outcome Score (FAOS). The Magnetic
Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess
cartilage incorporation. Fifty-six (64%) males and 31 (36%) females with mean clinical
follow-up of 47.2 months were included in this study. OCL defect size was significantly
larger in male patients (112.8 mm2) when compared with female patients (88.7 mm2) (p < .001). Male patients presented with a lesion associated with a recognized trauma
(p < .006) when compared with female patients who typically presented with associated
chronic ankle instability. Mean FAOS improved pre- to postoperatively from 50 to 81
(p < .001) with a statistically significant increase found in male patients (p < .001). The mean MOCART score was 82.1 in male and 86.7 female patients (p < .001). Our study demonstrates potential gender-related differences in the presentation
and mechanism of injury in the development of OCLs. It is also not unreasonable to
suggest that there may also be differences in treatment and rehabilitation strategies
to reduce the risk of developing OCLs in men and women.
Level of Clinical Evidence
Keywords
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References
- Autologous osteochondral transplantation for osteochondral lesions of the talus.Foot Ankle Int. 2016; 37: 363-372
- Arthroscopic findings in acute fractures of the ankle.J Bone Joint Surg Br. 2000; 82-B: 345-351
- Lesion size is a predictor of clinical outcomes after bone marrow stimulation for osteochondral lesions of the talus: a systematic review.Am J Sports Med. 2017; 45: 1698-1705
- Good clinical and functional outcomes at mid-term following autologous osteochondral transplantation for osteochondral lesions of the talus.Knee Surg Sports Traumatol Arthrosc. 2018; 26: 3055-3062
- Anterolateral tibial osteotomy for accessing osteochondral lesions of the talus in autologous osteochondral transplantation: functional and t2 MRI analysis.Foot Ankle Int. 2015; 36: 531-538
- Autologous osteochondral transplantation for large osteochondral lesions of the talus is a viable option in an athletic population.Am J Sports Med. 2019; 47: 3429-3435
- Ankle morphometry on 3D-CT images.The Iowa Orthop J. 2006; 26: 1-4
- Gender variation in the shape of superior talar dome: a cadaver measurement based on Chinese population.Biomed Res Int. 2018; 2018: 1-7
- Different patterns of cartilage mineralization analyzed by comparison of human, porcine, and bovine laryngeal cartilages.J Histochem Cytochem. 2017; 65: 367-379
- The influence of sex on the chondrogenic potential of muscle-derived stem cells: Implications for cartilage regeneration and repair.Arthritis Rheum. 2008; 58: 3809-3819
- Ankle ligament injury risk factors: a prospective study of college athletes.J Orthop Res. 2001; 19: 213-220
- Sex differences, hormone fluctuations, ankle stability, and dynamic postural control.J Athlet Train. 2012; 47: 143-148
- Intrinsic risk factors for inversion ankle sprains in male subjects: a prospective study.Am J Sports Med. 2005; 33: 415-423
- The treatment of osteochondral lesions of the talus with autologous osteochondral transplantation and bone marrow aspirate concentrate: surgical technique.Cartilage. 2011; 2: 327-336
- Sex- and gender-specific analysis in orthopaedic studies.Clin Orthop. 2020; : 1482-1488
- Risk factors for syndesmotic and medial ankle sprain: role of sex, sport, and level of competition.Am J Sports Med. 2011; 39: 992-998
- Validation of the foot and ankle outcome score for ankle ligament reconstruction.Foot Ankle Int. 2001; 22: 788-794
- Sex differences in three-dimensional talocrural and subtalar joint kinematics during stance phase in healthy young adults.Hum Mov Sci. 2018; 61: 117-125
- Sex differences in whole body gait kinematics at preferred speeds.Gait Posture. 2015; 41: 540-545
- Gender differences in adult foot shape: implications for shoe design.Med Sci Sports Exerc. 2001; : 605-611
- Morphological variations of the human talus investigated using three-dimensional geometric morphometrics.Clin Anat. 2020; : 536-543
- Differences in men's and women's mean ankle ligamentous laxity.Iowa Orthop J. 2000; 20: 46-48
- Magnetic resonance imaging evidence of postoperative cyst formation does not appear to affect clinical outcomes after autologous osteochondral transplantation of the talus.Arthroscopy. 2016; 32: 1846-1854
- Donor sex and age influence the chondrogenic potential of human femoral bone marrow stem cells.Osteoarthr Cartil. 2010; 18: 705-713
- Factors affecting knee cartilage volume in healthy men.Rheumatology (Oxford). 2003; 42: 258-262
- Human articular chondrocytes exhibit sexual dimorphism in their responses to 17β-estradiol.Osteoarthr Cartil. 2005; 13: 330-337
- Sexual dimorphism of the foot and ankle.Orthop Clin North Am. 2006; 37: 569-574
- Incidence of osteochondral lesions of the talus in the United States military.Foot Ankle Int. 2011; 32: 948-954
Article info
Publication history
Published online: May 17, 2022
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: Dr John G. Kennedy is a consultant for Arteriocyte, Inc and Arthrex Inc; is a board member for the International Society for Cartilage Repair of the Ankle, American Orthopaedic Foot and Ankle Society Awards and Scholarships Committee, International Cartilage Repair Society finance board. Dr Gino M.M.J. Kerkhoffs is a consultant for Arthrex Inc and is a board member of the International Society for Cartilage Repair of the Ankle. Dr Mary Mulcahey is a board member or member of the following: AAOS, American Journal of Sports Medicine Electronic Media, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, Arthroscopy, AANA, Ortho Info, RJOS, The Forum and a paid presenter for Arthrex, Inc. Dr Arianna Gianakos, Sean Flynn, and Okedele Olasunmbo have no conflicts to disclose.
Ethical Approval: IRB approval.
Informed Consent: Not available.
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