AUTOLOGOUS MOSAIC OSTEOCHONDROPLASTY IN THE TREATMENT OF TALAR OSTEOCHONDRAL DEFECTS

Background: Osteochondral defects of the talus (ODT) is a relatively rare, mostly traumatic pathology, in 6.5 % of cases complicate the course of inversion and eversion injuries of the foot and ankle [1]. Objectives: To conduct a clinical analysis of the effectiveness of autologous mosaic osteochondroplasty in the treatment of patients with osteochondral defects of the talus on the basis of determining the dynamics of pain and restoring the amplitude of ankle movements. Methods: The study included 34 patients with post-traumatic osteochondral defects of the talus (27 men, 7 women, mean age 24.8 ± 2.1 years) who underwent osteochondroplasty. The duration of painful clinical symptoms before osteochondroplasty ranged from 4 to 18 months. Functional treatment outcomes were assessed over a period of 12 to 36 months using the International Foot and Ankle Surgery Scale (AOFAS), pain dynamics were assessed using the Visual Analog Scale (VAS), and ankle movement recovery dynamics were determined. Results: Osteochondral autologic grafts were removed from the lateral condyle of the ipsilateral femur. Defect sizes: square from 82 to 129 mm (110,3 ± 0.8 mm ), depth from 7 to 16 mm (12 ± 0,8 mm). Incorporation of the graft in the recipient bed occurred within 1,5 – 3 months. Long-term follow-up was 12 – 36 months (22,8 ± 3,8 months). The level of pain was decreased from 5,7 ± 0,3 before to 0,9 ± 0,3 after the operation (p < 0.001; paired t-test). Improving of foot function according to AOFAS scale (hindfoot section) was established from 64,9 ± 1,4 to 95,9 ± 1,1 (p < 0.001; paired t-test). Extension increasing from 15,0 ± 0,9 to 18,4 ± 0,7 and flexion increasing from 22,9 ± 1,2 to 30,7 ± 1,1 was registered. There were no cases of implants failure or their instability neither the increasing of degenerative changes in the ankle joint. Conclusion: Osteochondroplasty is the effective method of congruity restoration in cases of post-traumatic talus osteochondral defects, promotes a significant reduction in pain syndrome and an improvement in the function of the ankle. The unknown mechanism of the analgesic effect of osteochondroplasty requires further research. REFERENCES: [1]O’Loughlin PF, Heyworth BE, Kennedy JG. Current concepts in the diagnosis and treatment of osteochondral lesions of the ankle. Am J Sports Med. 2010;38:392-404. doi: 10.1177/0363546509336336. Disclosure of Interests: None declared Citation: , volume 81, supplement 1, year 2022, page 1725Session: Spine, mechanical musculoskeletal problems, local soft tissue disorders (Publication Only)