Abstract
Introduction and purpose: To assess the results of the reconstruction of osteochondral lesions and transchondral fractures of the talus by means of mosaicoplasty.
Materials and methods: 20 patients (mean age: 30) were operated on in 3.5 years, with a minimal follow-up of 6 months. There were 17 medial and 3 lateral lesions. Ferkel’s and Sgaglioni’s classifications were used for the CT images. Medial lesions were approached by means of an osteotomy of the tibial malleolus. Lateral lesions were treated either directly or through an osteotomy of the fibular malleolus. Chondral lesions were debrided; the cylindrical osteochondral grafts were harvested from either the upper part of the femoral condyle or the anterior part of the talus. They were subsequently inserted into the talar dome. An average of three grafts were used (range: 1–7 tesseras). Patients non-weight bearing for 2–4 weeks. Movement was allowed after 7 days postop.
Results: Results were assessed by means of the Hannover and the Bandi scores. With the former, 94% of cases had excellent or good results; with the latter 94.7 % results were good with no knee morbility or talar complications. Complications: one case had a superficial infection.
Conclusions: In a mosaicoplasty there is either a replacement of the damaged bone or a filling of defect in the cartilage. The rehabilitation time is short and no painful sequela remain in the donor joint.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be sent to him at Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos, 108, 28015-Madrid, Spain
