Progress in surgical treatment of osteochondral lesion of talus

Objective: To provide a comprehensive overview of the surgical treatments of osteochondral lesion of talus (OLT) and offer valuable insights for clinical practice.

Methods: The advantages and limitations of surgical treatments for OLT were comprehensively summarized through an extensive review of domestic and abroad relevant literature in recent years.

Results: Currently, there exist numerous surgical treatments for the OLT, all of which can yield favorable outcomes. However, each method possesses its own set of merits and demerits. The short-term effectiveness of bone marrow stimulation in treating primary OLT with a diameter less than 15 mm is evident, but its long-term effectiveness diminishes over time. Autologous osteochondral transplantation (AOT) and osteochondral allograft transplantation (OAT) are suitable for OLT with large defects and subchondral bone cysts. However, incomplete anatomical matching between the donor and recipient bones may results in the formation of new subchondral bone cysts, while AOT also presents potential complications at the donor site. In contrast to AOT and OAT, particulated juvenile cartilage allograft transplantation obviates the need for additional osteotomy. Furthermore, juvenile cartilage exhibits enhanced potential in delivering active chondrocytes to the site of cartilage defect, surpassing that of adult cartilage in tissue repair efficacy. Cell transplantation has demonstrated satisfactory effectiveness; however, it is associated with challenges such as the requirement for secondary surgery and high costs. Autologous matrix-induced chondrogenesis technology has shown promising effectiveness in the treatment of primary and non-primary OLT and OLT with large defect and subchondral bone cysts. However, there is a scarcity of relevant studies, most of which exhibit low quality. Adjuvant therapy utilizing biological agents represents a novel approach to treating OLT; nevertheless, due to insufficient support from high-quality studies, it has not exhibited significant advantages over traditional treatment methods. Furthermore, its long-term effectiveness remain unclear.

Conclusion: The optimal choice of surgical treatment for OLT is contingent not only upon the characteristics such as nature, size, and shape but also takes into consideration factors like advancements in medical technology, patient acceptance, economic status, and other pertinent aspects to deliver personalized treatment.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:38

Enthalten in:

Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery - 38(2024), 3 vom: 15. März, Seite 373-379

Sprache:

Chinesisch

Beteiligte Personen:

Jiang, Ning [VerfasserIn]
Xu, Guijun [VerfasserIn]
Li, Haomin [VerfasserIn]
Yang, Jinming [VerfasserIn]
Wang, Jia [VerfasserIn]
Shen, Lin [VerfasserIn]
Zeng, Xiantie [VerfasserIn]

Links:

Volltext

Themen:

English Abstract
Journal Article
Osteochondral lesion
Review
Surgical treatment
Talus

Anmerkungen:

Date Completed 20.03.2024

Date Revised 02.04.2024

published: Print

Citation Status MEDLINE

doi:

10.7507/1002-1892.202311097

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369900758