The Journal of Bone and Joint Surgery (American). 2007;89:170-182.
doi:10.2106/JBJS.G.00169
© 2007 The Journal of Bone and Joint Surgery, Inc.
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The Surgical Technique of Autologous Chondrocyte Transplantation of the Talus with Use of a Periosteal Graft

Surgical Technique

Mike H. Baums, MD1, Gabert Heidrich, MD1, Wolfgang Schultz, MD, PhD1, Hanno Steckel, MD1, Enrico Kahl, MD1 and Hans-Michael Klinger, MD1

1 Departments of Orthopaedic Surgery (M.H.B., W.S., H.S., E.K., and H.-M.K.) and Radiology (G.H.), Georg-August University Göttingen, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany. E-mail address for M.H. Baums: mike.baums{at}freenet.de

Investigation performed at the Departments of Orthopaedic Surgery and Radiology, Georg-August University Göttingen, Göttingen, Germany

The original scientific article in which the surgical technique was presented was published in JBJS Vol. 88-A, pp. 303-8, February 2006

DISCLOSURE: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

NOTE: The authors thank Katharina Sames, MD, for creating the anatomical line drawings in this report.

The line drawings in this article are the work of Jennifer Fairman (jfairman{at}fairmanstudios.com). The drawings were based on illustrations by Katharina Sames, MD.

BACKGROUND: Despite its highly specialized nature, articular cartilage has a poor reparative capability. Treatment of symptomatic osteochondral defects of the talus has been especially difficult until now.

METHODS: We performed autologous chondrocyte transplantation in twelve patients with a focal deep cartilage lesion of the talus. There were seven female and five male patients with a mean age of 29.7 years. The mean size of the lesion was 2.3 cm2. All patients were studied prospectively. Evaluation was performed with use of the Hannover ankle rating score, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, a visual analog scale for pain, and magnetic resonance imaging.

RESULTS: All patients were available for follow-up at a mean of sixty-three months. There was a significant improvement in the Hannover score, from 40.4 points preoperatively to 85.5 points at the follow-up examination, with seven excellent results, four good results, and one satisfactory result. The AOFAS mean score was 88.4 points compared with 43.5 points preoperatively. Magnetic resonance imaging showed a nearly congruent joint surface in seven patients, discrete irregularities in four, and an incongruent surface in one. The patients who had been involved in competitive sports were able to return to their full activity level.

CONCLUSIONS: The promising clinical results of this study suggest that autologous chondrocyte transplantation is an effective and safe way to treat symptomatic osteochondral defects of the talus in appropriately selected patients.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION: "Autologous Chondrocyte Transplantation for Treating Cartilage Defects of the Talus" (2006;88:303-8).


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Related articles in JBJS:

Autologous Chondrocyte Transplantation for Treating Cartilage Defects of the Talus
M.H. Baums, G. Heidrich, W. Schultz, H. Steckel, E. Kahl, and H.-M. Klinger
JBJS 2006 88: 303-308. [Abstract] [Full Text]