Abstract：
There are few studies on the clinical outcomes of osteochondral autologous transplantation (OAT) harvesting from local talar non-weight-bearing articular facets for the treatment of osteochondral lesions of the talus (OLTs). The purpose of this study was to review the short- to midterm outcomes of our patients who were treated with OAT harvesting from ipsilateral talar articular facets for OLTs.
Between December 2010 and November 2018, 24 patients were enrolled in this study. There were 16 males and eight females with an average age of 39.1 years and a follow-up period of 50.9 months. The clinical results were evaluated according to the American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS) score. Pre-operative plain radiographs and magnetic resonance imaging (MRI) scans, post-operative radiographs, and X-ray and computed tomography (CT) scans at the last follow-up were observed.
There was a significant improvement in the AOFAS score from 61.3 ± 19.0 pre-operatively to 84.9 ± 9.2 post-operatively (P < 0.001). The VAS score improved from 6.1 ± 2.3 to 2.0 ± 1.4 at the last follow-up (P < 0.001). Twenty-one patients (87.5%) were satisfied with their clinical results. By the last follow-up CT scan, there was bone cyst formation at the donor sites in three patients, at the recipient sites in five patients and at both sites in five patients. Two patients (8.3%) underwent re-operation with arthroscopic debridement because of medial gutter hypertrophic soft tissue impingement.
OAT harvesting from the ipsilateral talar articular facet showed satisfactory results. The mean post-operative VAS score and AOFAS ankle-hindfoot score improved significantly. Post-operative impingement around the osteotomy site was the main complication and reason for re-operation after the index procedure. In addition, bone cysts at the recipient and/or donor site(s) were found with a large percentage under CT. Therefore, longer follow-up is necessary to determine the long-term clinical results for this technique.
Between December 2010 and November 2018, 24 patients were enrolled in this study. There were 16 males and eight females with an average age of 39.1 years and a follow-up period of 50.9 months. The clinical results were evaluated according to the American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS) score. Pre-operative plain radiographs and magnetic resonance imaging (MRI) scans, post-operative radiographs, and X-ray and computed tomography (CT) scans at the last follow-up were observed.
There was a significant improvement in the AOFAS score from 61.3 ± 19.0 pre-operatively to 84.9 ± 9.2 post-operatively (P < 0.001). The VAS score improved from 6.1 ± 2.3 to 2.0 ± 1.4 at the last follow-up (P < 0.001). Twenty-one patients (87.5%) were satisfied with their clinical results. By the last follow-up CT scan, there was bone cyst formation at the donor sites in three patients, at the recipient sites in five patients and at both sites in five patients. Two patients (8.3%) underwent re-operation with arthroscopic debridement because of medial gutter hypertrophic soft tissue impingement.
OAT harvesting from the ipsilateral talar articular facet showed satisfactory results. The mean post-operative VAS score and AOFAS ankle-hindfoot score improved significantly. Post-operative impingement around the osteotomy site was the main complication and reason for re-operation after the index procedure. In addition, bone cysts at the recipient and/or donor site(s) were found with a large percentage under CT. Therefore, longer follow-up is necessary to determine the long-term clinical results for this technique.
摘要：
关于从距骨局部非负重关节面获取骨软骨自体移植（OAT）治疗距骨骨软骨病变（OLTs）的临床结果的研究很少。这项研究的目的是回顾我们的患者的短期到中期结果，这些患者从同侧距骨关节小平面收获OAT治疗OLT。
2010年12月至2018年11月，24名患者被纳入本研究。男性16例，女性8例，平均年龄39.1岁，随访时间50.9个月。根据美国骨科足踝协会（AOFAS）踝足-后足评分和视觉模拟评分（VAS）评分对临床结果进行评估。术前平片和磁共振成像（MRI）扫描，术后X光片,最后随访时进行X线和计算机断层扫描（CT）扫描。
AOFAS评分从术前61.3±19.0显著改善至术后84.9±9.2(P<0.001)。末次随访时VAS评分由6.1±2.3提高至2.0±1.4(P<0.001)。21例患者（87.5％）对其临床结果感到满意。最后一次CT扫描,三名患者的供体部位有骨囊肿形成，五名患者的受体部位和五名患者的两个部位。两名患者（8.3％）由于内侧沟肥厚性软组织撞击而接受了关节镜清理术的再次手术。
从同侧距骨关节小关节收获OAT显示令人满意的结果。术后平均VAS评分和AOFAS踝足-后足评分明显改善。术后截骨部位周围撞击是索引程序后再次手术的主要并发症和原因。此外,在CT下发现受体和/或供体部位的骨囊肿有很大比例。因此,需要更长时间的随访才能确定该技术的长期临床结果.
2010年12月至2018年11月，24名患者被纳入本研究。男性16例，女性8例，平均年龄39.1岁，随访时间50.9个月。根据美国骨科足踝协会（AOFAS）踝足-后足评分和视觉模拟评分（VAS）评分对临床结果进行评估。术前平片和磁共振成像（MRI）扫描，术后X光片,最后随访时进行X线和计算机断层扫描（CT）扫描。
AOFAS评分从术前61.3±19.0显著改善至术后84.9±9.2(P<0.001)。末次随访时VAS评分由6.1±2.3提高至2.0±1.4(P<0.001)。21例患者（87.5％）对其临床结果感到满意。最后一次CT扫描,三名患者的供体部位有骨囊肿形成，五名患者的受体部位和五名患者的两个部位。两名患者（8.3％）由于内侧沟肥厚性软组织撞击而接受了关节镜清理术的再次手术。
从同侧距骨关节小关节收获OAT显示令人满意的结果。术后平均VAS评分和AOFAS踝足-后足评分明显改善。术后截骨部位周围撞击是索引程序后再次手术的主要并发症和原因。此外,在CT下发现受体和/或供体部位的骨囊肿有很大比例。因此,需要更长时间的随访才能确定该技术的长期临床结果.
