Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation ± Calcaneal Autograft : A Cohort Study
© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature..
BACKGROUND: Osteochondral lesions of the talus (OCLT) are common injuries that can be difficult to treat. To date, long-term patient reported outcome measures (PROMs) of patients with particulated juvenile allograft cartilage implantation with or without calcaneal autograft have not been compared.
METHODS: Thirteen patients with difficult to treat OCLTs underwent arthroscopic-assisted implantation of particulated juvenile allograft cartilage (DeNovo NT®) with or without autogenous calcaneal bone grafting by a single surgeon. Calcaneal bone graft use was determined by lesion size > 150 mm2 and/or deeper than 5 mm. Patients were evaluated using physical examination, patient interviews, and PROMs.
RESULTS: When comparing patients in regards to calcaneal bone graft implantation, no difference in age, BMI, pre-operative PROMs, or follow-up was noted, however, calcaneal bone graft patients did have a significantly larger lesion size (188.5 ± 50.9 vs. 118.7 ± 29.4 mm2 respectively; p value = 0.027). VAS and FAAM ADL scores during final follow-up improvement did not significantly differ between cohorts. The FAAM Sports score improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.032). The AOFAS score improvement did not differ between cohorts (p value = 0.944), however, the SF-36 PCS improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.038). No intraoperative/perioperative complications were observed with calcaneal bone grafting.
CONCLUSION: While patients followed over the course of ~ 8 years after implantation of particulated juvenile allograft cartilage (DeNovo NT®) with/without autogenous calcaneal bone graft had positive post-operative PROMs, patients without calcaneal bone graft had significantly greater improvement in functional outcome scores. Whether these differences are due to graft incorporation or larger lesion size is unclear.
LEVEL OF EVIDENCE: III, retrospective cohort study.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie - 34(2024), 1 vom: 05. Jan., Seite 561-568 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Manzi, Joseph E [VerfasserIn] |
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Journal Article |
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| Anmerkungen: |
Date Completed 08.01.2024 Date Revised 08.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00590-023-03642-7 |
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| PPN (Katalog-ID): |
NLM361488181 |
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| 100 | 1 | |a Manzi, Joseph E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation ± Calcaneal Autograft |b A Cohort Study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature. | ||
| 520 | |a BACKGROUND: Osteochondral lesions of the talus (OCLT) are common injuries that can be difficult to treat. To date, long-term patient reported outcome measures (PROMs) of patients with particulated juvenile allograft cartilage implantation with or without calcaneal autograft have not been compared | ||
| 520 | |a METHODS: Thirteen patients with difficult to treat OCLTs underwent arthroscopic-assisted implantation of particulated juvenile allograft cartilage (DeNovo NT®) with or without autogenous calcaneal bone grafting by a single surgeon. Calcaneal bone graft use was determined by lesion size > 150 mm2 and/or deeper than 5 mm. Patients were evaluated using physical examination, patient interviews, and PROMs | ||
| 520 | |a RESULTS: When comparing patients in regards to calcaneal bone graft implantation, no difference in age, BMI, pre-operative PROMs, or follow-up was noted, however, calcaneal bone graft patients did have a significantly larger lesion size (188.5 ± 50.9 vs. 118.7 ± 29.4 mm2 respectively; p value = 0.027). VAS and FAAM ADL scores during final follow-up improvement did not significantly differ between cohorts. The FAAM Sports score improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.032). The AOFAS score improvement did not differ between cohorts (p value = 0.944), however, the SF-36 PCS improved significantly more for the DeNovo alone group compared to the bone graft cohort (p value = 0.038). No intraoperative/perioperative complications were observed with calcaneal bone grafting | ||
| 520 | |a CONCLUSION: While patients followed over the course of ~ 8 years after implantation of particulated juvenile allograft cartilage (DeNovo NT®) with/without autogenous calcaneal bone graft had positive post-operative PROMs, patients without calcaneal bone graft had significantly greater improvement in functional outcome scores. Whether these differences are due to graft incorporation or larger lesion size is unclear | ||
| 520 | |a LEVEL OF EVIDENCE: III, retrospective cohort study | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Juvenile articular cartilage implantation | |
| 650 | 4 | |a Microfracture | |
| 650 | 4 | |a Osteochondral defects | |
| 650 | 4 | |a Talar osteochondral lesions | |
| 650 | 4 | |a Talus | |
| 700 | 1 | |a Manchanda, Kshitij |e verfasserin |4 aut | |
| 700 | 1 | |a Nasra, Matthew H |e verfasserin |4 aut | |
| 700 | 1 | |a Sudah, Suleiman Y |e verfasserin |4 aut | |
| 700 | 1 | |a Coladonato, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Quan, Theodore |e verfasserin |4 aut | |
| 700 | 1 | |a Wishman, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Moran, Jay |e verfasserin |4 aut | |
| 700 | 1 | |a Murray, Daniel P |e verfasserin |4 aut | |
| 700 | 1 | |a Chapman, Cary B |e verfasserin |4 aut | |
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