Long-term outcome for repair of osteochondral lesions of the talus by osteochondral autograft: A series of 56 Mosaicplasties® - 26/10/21

Doi : 10.1016/j.otsr.2021.103075

Nicolas de l’Escalopier ^a,⁎ , Thomas Amouyel ^b, Didier Mainard ^c, Ronny Lopes ^d, Guillaume Cordier ^e, Nicolas Baudrier ^f, Jonathan Benoist ^g, Victor Dubois Ferrière ^h, Fréderic Leiber ⁱ, Antoine Morvan ^f, Carlos Maynou ^b, Giovany Padiolleau ^d, Olivier Barbier ^j
the Francophone Arthroscopy Society (SFA)^k
^a Service de Chirurgie Orthopédique, Traumatologique et Réparatrice des Membres, HIA Percy, 101, avenue Henri Barbusse, 92140 Clamart, France
^b Hôpital Salengro, Service de Chirurgie Orthopédique, 2, avenue Oscar Lambret, 59000 Lille, France
^c Hôpital Central, 29, avenue du Maréchal de Lattre de Tassigny, 54000 Nancy, France
^d Centre PCNA, avenue Claude Bernard, 44800 Saint-Herblain, France
^e Centre de Chirurgie Orthopédique et Sportive, 2, rue Georges Negrevergne, 33700 Mérignac, France
^f Hôpital Ambroise Paré, Service de Chirurgie Orthopédique, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
^g Institut Locomoteur de l’Ouest, 7, boulevard de la Boutière, 35760 Saint-Grégoire, France
^h Centre Assal de Médecine et de Chirurgie du Pied, avenue de Beau-Séjour 6, 1206 Geneva, Switzeraland
ⁱ Clinique de l’Orangerie, 29, allée de la Robertsau, 67000 Strasbourg, France
^j Service de Chirurgie Orthopédique et Traumatologique, HIA Sainte Anne, 2, boulevard Sainte-Anne, 83800 Toulon, France
^k 15, rue Ampère, 92500 Rueil Malmaison, France

^⁎Corresponding author.

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Abstract

Introduction

The present study analyzed results in 56 osteochondral Mosaicplasty® autografts for osteochondral lesion of the talus (OLT) at more than 5 years’ follow-up.

Hypothesis

Mosaicplasty® shows long-term efficacy and low morbidity in the treatment of OLT.

Patients and methods

A multicenter retrospective study included patients treated by Mosaicplasty® with more than 5 years’ follow-up. Preoperative data were collected from medical files, and all patients were reassessed. AOFAS scores and FAOS were calculated at last follow-up. Imaging comprised standard radiographs and MRI or CT arthrography of the ankle.

Results

Fifty-six patients were included, with a mean age of 34 years (range, 18-60 years). Seventeen involved work accidents. Mean follow-up was 8.5 years (range, 5-20 years). Mean AOFAS score at follow-up was 80.6±19.4 and mean FAOS 77.8±21.5. Work accident, preoperative osteoarthritis and untreated laxity correlated significantly with poorer results. At last follow-up, 22 patients (39%) showed signs of osteoarthritis. There was no morbidity implicating the malleolar osteotomy. There were 11 cases (20%) of persistent patellar syndrome at the donor site.

Discussion

The present results were comparable to those reported elsewhere, showing that functional results of Mosaicplasty® autograft for OLT do not deteriorate over the long term. Work accidents correlated significantly with poorer functional outcome. Any associated instability must always be treated. Malleolar osteotomy provides good exposure without additional morbidity.