Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal Autograft
Category: Ankle; Other Introduction/ Purpose: 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 a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-12-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011423S00170 |
| _version_ | 1797375446364454912 |
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| author | Joseph Manzi MD Kshitij Manchanda MD Matthew Nasra MD Suleiman Sudah MD Carlo Coladonato MS Theodore Quan BS Mark Wishman BS Jay Moran BS Daniel P. Murray MD Cary Chapman MD |
| author_facet | Joseph Manzi MD Kshitij Manchanda MD Matthew Nasra MD Suleiman Sudah MD Carlo Coladonato MS Theodore Quan BS Mark Wishman BS Jay Moran BS Daniel P. Murray MD Cary Chapman MD |
| author_sort | Joseph Manzi MD |
| collection | DOAJ |
| description | Category: Ankle; Other Introduction/ Purpose: 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: From 2010-2012, 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 mm 2 and/or deeper than 5 mm. Patients were evaluated using physical examination, patient interviews, and PROMs. Pre-operative and post-operative PROMs were compared with a Mann Whitney test. 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±29.4mm 2 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. |
| first_indexed | 2024-03-08T19:24:30Z |
| format | Article |
| id | doaj.art-642eea26431b4d15adbc6fb56f67f77b |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-03-08T19:24:30Z |
| publishDate | 2023-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-642eea26431b4d15adbc6fb56f67f77b2023-12-26T10:04:44ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142023-12-01810.1177/2473011423S00170Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal AutograftJoseph Manzi MDKshitij Manchanda MDMatthew Nasra MDSuleiman Sudah MDCarlo Coladonato MSTheodore Quan BSMark Wishman BSJay Moran BSDaniel P. Murray MDCary Chapman MDCategory: Ankle; Other Introduction/ Purpose: 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: From 2010-2012, 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 mm 2 and/or deeper than 5 mm. Patients were evaluated using physical examination, patient interviews, and PROMs. Pre-operative and post-operative PROMs were compared with a Mann Whitney test. 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±29.4mm 2 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.https://doi.org/10.1177/2473011423S00170 |
| spellingShingle | Joseph Manzi MD Kshitij Manchanda MD Matthew Nasra MD Suleiman Sudah MD Carlo Coladonato MS Theodore Quan BS Mark Wishman BS Jay Moran BS Daniel P. Murray MD Cary Chapman MD Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal Autograft Foot & Ankle Orthopaedics |
| title | Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal Autograft |
| title_full | Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal Autograft |
| title_fullStr | Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal Autograft |
| title_full_unstemmed | Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal Autograft |
| title_short | Long-Term Patient Outcomes for Treatment of Difficult Osteochondral Lesions of the Talus with Particulated Juvenile Allograft Cartilage Implantation with and without Calcaneal Autograft |
| title_sort | long term patient outcomes for treatment of difficult osteochondral lesions of the talus with particulated juvenile allograft cartilage implantation with and without calcaneal autograft |
| url | https://doi.org/10.1177/2473011423S00170 |
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