Treatment of talar osteochondral defect with peroneus longus tendon autograft

Year 2022, , 187 - 192, 30.09.2022

Mehmet Emin Dada , Orkun Gül , Sezgin Açıl , Muhammet Salih Ayas , Ahmet Uğur Turhan

https://doi.org/10.47482/acmr.1095702

Abstract

Background: Tendon autograft has been used in Freiberg’s disease, capitellar osteochondritis dissecans, and osteochondral defect in the knee joint. The aim of this study was to evaluate the clinical and radiological results of patients treated with tendon autografts in the treatment of talus osteochondral defect (TOD), and to compare the results of this treatment with other treatment modalities in light of the literature.

Methods: The study was carried out with patients who were treated for TOD with peroneus longus tendon otograft between 2009-2017. 17 ankles of 15 patients were included in the study. The patients who were operated had osteochondral lesions that were Berndt and Harty stage III-IV on radiographs, and Hepple stage III-IV-V on magnetic resonance imaging (MRI). American Orthopedic Foot and Ankle Score (AOFAS) was used for clinical evaluation. Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) classification was used for postoperative radiological evaluation.

Results: The mean age of the patients was 31.9±14.1 (min 17-max 64) years. The mean follow-up period was 23.9±28.7 (min 6-max 120) months. The mean defect size was 1.7±0.7 (min 0.9-max 3.3) cm². The mean AOFAS score was 50.1±15.7 (min 24-max 77) preoperatively and 90.8±7.7 (min 70-max 100) postoperatively. The mean MOCART score was calculated as 87.1±3.1 (min 80-max 90). Postoperative osteoarthritis was not detected in any of the direct radiographs of the patients.

Conclusions: Tendon autograft was considered to be a reliable, easy, cheap and one-step method that can be used in TOD treatment.

Keywords

Ankle Joint, Osteochondral Defect, Scaffold, Tendon Autograft.

References

• 1. Chao J, Pao A. Restorative tissue transplantation options for osteochondral lesions of the talus: A Review. Orthop Clin N Am. 2017;48:371-83.
• 2. Flick AB, Gould N. Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. Foot Ankle. 1985;5:165-85.
• 3. Sellards RA, Nho SJ, Cole BJ. Chondral injuries. Curr Opin Rheumatol. 2002;14:34-141.
• 4. Davies-Tuck ML, Wluka AE, Wang Y, English DR, Giles GG, Cicuttini FM. The natural history of cartilage defects in people with knee osteoarthritis. Osteoarthr Cartil. 2008;16:337-42.
• 5. Easley ME. Osteochondral lesions of the talus: diagnosis and treatment. Ankle and foot. Curr Opin Orthop. 2003;14:69-73.
• 6. Chodos MD, Schon LC. Osteochondral lesions of the talus: current treatment modalities and future possibilities. Ankle and foot. Curr Opin Orthop. 2006;17:111-6.
• 7. Giannini S, Buda R, Faldini C, et al. Surgical treatment of osteochondral lesions of the talus in young active patients. J Bone Joint Surg. 2005;87A Suppl 2:28-41.
• 8. Sexton AT, Labib SA. Osteochondral lesions of the talus: current opinions on diagnosis and management. Sports medicine. Curr Opin Orthop. 2007;18:166- 71.
• 9. Gross CE, Adams SB, Easley ME, Nunley JA. Role of fresh osteochondral allografts for large talar osteochondral lesions. J Am Acad Orthop Surg. 2016;24:9-17.
• 10. Turhan AU, Açıl S, Gül O, Öner K, Okutan AE, Ayas MS. Retrospective Study Treatment of knee osteochondritis dissecans with autologous tendon transplantation: Clinical and radiological results. World J Orthop 2021 November 18;12(11):867-876
• 11. Okutan AE, Ayas MS, Öner K, Turhan AU. Metatarsal Head Restoration With Tendon Autograft in Freiberg’s Disease: A Case Report. J Foot Ankle Surg. 2020;59(5):1109-12
• 12. Aydın H, Karahasanoğlu İ, Kerimoğlu S, Turhan AU. Treatment of capitellar osteochondritis dissecans with a tendon graft: a case report. Jt Dis Relat Surg. 2012;23(1):55-57
• 13. Turhan AU, Aynacı O, Turgutalp A, Aydın H. Treatment of osteochondral defects with tendon autografts in a dog knee model. Knee Surg Sports Traumatol Arthrosc. 1999;7:64-6
• 14. Almekinders LC, Banes AJ, Ballenger CA. Effects of repetitive motion on human fibroblasts. Med SciSports Exerc. 1993;25(5):603-7.
• 15. Wang JH, Jia F, Yang G, Yang S, Campbell BH, Stone D, et al. Cyclic mechanical stretching of human tendon fibroblasts increases the production of prostaglandin E2 and levels of cyclooxygenase expression: a novel in vitro model study. Connect Tissue Res. 2003;44(3-4):128-33.
• 16. Banes AJ, Donlon K, Link GW, Gillespie Y, Bevin AG, Peterson HD, et al. Cell populations of tendon: a simplified method for isolation of synovial cells and internal fibroblasts: confirmation of origin and biologic properties. J Orthop Res. 1988;6(1):83-94.
• 17. Bi Y, Ehirchiou D, Kilts TM, Inkson CA, Embree MC, Sonoyama W, et al. Identification of tendon stem/progenitor cells and the role of the extracellular matrix in their niche. Nat Med. 2007;13(10):1219-27.
• 18. de Mos M, Koevoet WJ, Jahr H, Verstegen MM, Heijboer MP, Kops N, et al. Intrinsic differentiation potential of adolescent human tendon tissue: an in-vitro cell differentiation study. BMC Musculoskelet Disord. 2007;8:16-27.
• 19. Zhang J, Wang JHC. Characterization of differential properties of rabbit tendon stem cells and tenocytes. BMC Musculoskelet Disord. 2010;11:10.