Effects Of Autogenous Osteochondral Transplantation On Pain And Joint Function In Patients With Osteochondral Lesions Of The Talus

Objective To observe the effects of autogenous osteochondral transplantation on pain and joint function in patients with osteochondral lesions of the talus.Methods We chose 23 cases of talus osteochondral damage in the Department of orthopedics,Tianjin Fifth Central Hospital Department of orthopedics,May 2013-2017,and the clinical data of 23 patients with osteochondral injury of the talus.The criteria included in this study were: 1.all patients were diagnosed with chronic pain in the ankle,which significantly affected the daily life or exercise quality of the patients.2.all the selected patients were confirmed by MRI to have osteochondral lesions of Hepple IV type and Hepple V type of subchondral bone cyst.3.all the patients were willing to receive autogenous osteochondral grafting to treat osteochondral lesions of the talus.The criteria for exclusion were: 1.malleolus malformation.2.the force line of the limb was bad.3.severe osteoarthritis and severe osteoporosis.4.had an ankle infection.5.non-traumatic lesions such as tumor.6.postoperative patients are not conducive to rehabilitation exercise factors(such as psychological fear of pain,and unwilling to accept this operation)patients.7.patients with heart,liver,kidney,lung and organ diseases are not easy to tolerate surgery.All the patients with the osteochondral injury of the talus were treated with autogenous osteochondral transplantation,and a special autogenous osteochondral instrument was used to drill the cartilage column from the lateral condyle of the femur or the non weight negative area of the medial condyle to be transplanted into the area of the cartilage injury of the talus and the appropriate iliac bone was transplanted to the lateral femur.In the condyle or medial condyle defect,whether this operation can reduce the pain of the knee joint and improve the function of the joint,and we instruct the patients to carry out the rehabilitation of the ankle joint after the operation.The follow-up time is from 12 months to 36 months.The average time of the follow-up is18 months,and the final statistics are made.The joint pain and joint function were compared before and after treatment.Result The results were all patients in this group were followed up.After the treatment,the visual pain scale(VAS)score,the Lysholm score,the IKDC score and the ankle ankle foot score(AOFAS)of the American foot and ankle surgery association were better than those before the treatment,and the range of ankle joint activity was better than before the treatment(P < 0.05);only 2 cases were followed up with the pain of the donor area.Pain,swelling,complication rate 8.70%,after symptomatic treatment,the donor area pain and swelling symptoms improved.Conclusion The osteochondral injury of the talus is treated with autogenous osteochondral transplantation.The follow-up results show that the operative method is an effective means to treat the injury of the talus cartilage.It can effectively reduce the pain of the ankle and improve the function of the joint.