Successful Treatment for Large Osteochondral Lesions of the Talus

Study shows significant improvement in patients treated with allograft transplantation

Rosemont, Illinois, UNITED STATES

Rosemont, Ill., July 11, 2022 (GLOBE NEWSWIRE) -- According to a new study published in Foot & Ankle International (FAI), patients suffering from large Osteochondral Lesions of the Talus (OLTs) reported pain relief and improved function following structural allograft transplantation, a surgical treatment that takes fresh bone from a cadaveric donor and implants it in the patient's ankle joint.

OLTs are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. As many as 85% of OLTs occur after an ankle sprain or traumatic injury. OLTs may soften the cartilage layers, cause cyst-like lesions, or fracture the cartilage and bone layers. Patients with OLTs may experience ankle pain, swelling, catching, or instability. Foot and ankle orthopaedic surgeons use imaging such as X-rays, CT scans, or an MRI to diagnose the condition.

If non-surgical treatment for OLTs does not relieve pain and other symptoms, surgery may be recommended. The osteochondral allograft transplantation procedure was developed to treat large, challenging lesions by transplanting a fresh (not frozen) bone from a cadaveric donor.

Researchers at Duke University Medical Center evaluated 31 patients who underwent structural fresh osteochondral allograft transplantation between 2007 and 2019. The evaluation included preoperative imaging, postoperative patient questionnaires administered yearly, and postoperative imaging checking for allograft assimilation, arthritic changes, and range of motion.

"Our research team set out to determine the results of cadaver bone transplantation for large osteochondral lesions of the talus," said Samuel B. Adams, MD, director of foot and ankle research at Duke University Medical Center and senior author of the study. "Although these large lesions are not common, they can be very painful and decrease quality of life. This is one of the few procedures available to surgeons to treat this pathology."

The study found patients experienced significant improvement in pain and function by 6 months after the treatment and maintained it at an average of 4.5 years postoperatively. Nearly half of the patients needed an additional operation to remove hardware. Dr. Adams noted that data supporting the success of this procedure is very important as it is still considered experimental by many insurance companies and is not widely performed by foot and ankle orthopaedic surgeons.

"This study shows that, in the hands of skilled surgeons, patients can expect good outcomes treating the challenging problem of a painful, large focal loss of ankle bone and cartilage," said Charles L. Saltzman, MD, FAI Editor-in-Chief.

The study, "Midterm Prospective Evaluation of Structural Allograft Transplantation for Osteochondral Lesions of the Talar Shoulder," appears in the May 2022 issue of Foot & Ankle International, the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). FAI is published by SAGE Journals


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