Abstract
Introduction Twelve patients with an osteochondral lesion of the talus were treated with excision of the lesions and local osteochondral autogenous grafting.
Methods The lesion was accessed through a replaceable bone block removed from the anterior tibial plafond. The graft was harvested from the medial or lateral talar articular facet on the same side of the lesion. The average age of the patients was 41 years and duration of symptoms was 90 months (average). There were six males and six females with the right talus involved in eight and the left in four patients. Graft sizes ranged from four to eight millimetres in diameter.
Results There was a significant improvement in the AOFAS score from 64.4 (average) pre-operatively to 90.8 (average post-operatively (p< 0.0001) at follow-up of 25.3 months (average). The AOFAS score was slightly higher in patients under 40 years of age and in those without pre-existing joint arthritis. All patients were very satisfied with the procedure. Arthroscopy performed in two patients at six and 12 months following surgery showed good graft incorporation. No complications occurred at the donor site or the site of the bone block removal on the distal tibia.
Conclusions The results showed that stage III and stage IV talar osteochondral lesions can be accessed successfully excising a tibial bone block and using local autogenous osteochondral graft harvested from the ipsilateral talar articular facet.
In relation to the conduct of this study, one or more of the authors has received, or is likely to receive direct material benefits.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
