Prospective comparison of two different surgical technique in the treatment of deep osteochondral lesions of the talus: mosaicplasty versus all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond.

Autor: Özyıldıran M; Department of Orthopedics and Traumatology, Sandıklı State Hospital, Afyonkarahisar, Turkey. mozyildiran@gmail.com., Armangil M; Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey., Özbek EA; Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey., Akmeşe R; Department of Orthopedics and Traumatology, Çankaya Hospital, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 Dec 16; Vol. 145 (1), pp. 46. Date of Electronic Publication: 2024 Dec 16.
DOI: 10.1007/s00402-024-05673-z
Abstrakt: Introduction: There are various surgical techniques applied for the treatment of osteochondral lesions of the talus (OLT). The mosaicplasty technique is one of the most commonly used methods for deep lesions. The all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond is a novel method as an alternative to the mosaicplasty. This study aims to compare the clinical and radiological results of these two different surgical techniques in the treatment of deep OLT.
Materials and Methods: From September 2019 to July 2021, 30 patients with deep osteochondral lesions of the talus were randomly divided into two groups for either mosaicplasty or the all-arthroscopic technique, and they were evaluated prospectively. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analog scale (VAS) scores were evaluated within and between groups preoperatively and postoperatively. Radiological assessments were performed at 6th and 12th month postoperatively according to the magnetic resonance observation of cartilage repair tissue (MOCART) scale.
Results: Mosaicplasty was applied to 15 patients, and all-arthroscopic technique was applied to 15 patients. 14 of the patients were female and 16 were male; the mean age was 38.1. Within-group evaluations revealed significant improvements in AOFAS and VAS scores at postoperative 6th and 12th months (p < 0.05). There was no significant difference between the treatment groups in comparison of clinical scores at any time period. There was no significant difference between the two methods according to the total MOCART scores (p > 0.05). However, the all-arthroscopic technique was more successful in terms of "border integration" and "repair tissue structure" (p < 0.05). Age, body mass index (BMI) and lesion surface area were not correlated with clinical scores.
Conclusions: In terms of clinical and radiological scores, similar results were obtained in the treatment groups. Both surgical techniques were found to be effective in the treatment of deep OLT.
Competing Interests: Declarations. Conflict of interest: None of the authors or any immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article. Ethical standard: The study protocol received institutional review board approval. Decree No: İ3-62-19. Informed consent: Informed consent was obtained from all individual participants included in the study.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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