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Purpose <p>Autologous osteoperiosteal transplantation (AOPT) from the iliac crest has been proposed as a potential treatment for large osteochondral lesions of the talus (OLTs). This single-arm study aims to prospectively evaluate the clinical, radiological, and arthroscopic outcomes of AOPT from the iliac crest in patients with large cystic OLTs.</p> Methods <p>This is a prospective single-arm study. We evaluated 42 patients who underwent AOPT from the iliac crest for OLTs. The mean follow-up was 32.5&#xa0;months. Clinical outcomes were assessed using the Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) scores, and Tegner activity scores. Radiologic outcomes were evaluated via X-ray, CT, and MRI. Arthroscopy was performed on a subset of patients for second-look evaluation.</p> Results <p>Significant clinical improvements were observed, with VAS scores decreasing from 4.36 ± 1.76 to 0.45 ± 0.63, AOFAS scores increasing from 75.38 ± 13.52 to 95.33 ± 4.81, and Tegner scores increasing from 2.00 ± 0.99 to 4.10 ± 1.10. Postoperative imaging revealed the resolution of subchondral radiolucency, improvement of articular surface protrusion or collapse, graft integration with surrounding bone, and a reduction in marrow oedema. Follow-up arthroscopy demonstrated significant lesion repair, with cartilage-like tissue integrated into the talus. No complications, including infections or donor-site morbidity, were observed.</p> Conclusion <p>AOPT from the iliac crest is associated with favourable short- to mid-term clinical, radiological, and arthroscopic outcomes, with no complications observed in this series. These findings provide prospective evidence supporting the potential of AOPT from the iliac crest as a treatment option for large talar osteochondral defects.</p>

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Autologous osteoperiosteal transplantation from the iliac crest for the treatment of large osteochondral lesions of the talus

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Yanbo Chen,
  • Yujun Sun,
  • Yong Li,
  • Jiayuan Zheng,
  • Jiajie Li,
  • Jionglin Wu,
  • Taolve Zhou,
  • Zhenxiang Zheng,
  • Wenzhou Liu,
  • Gang Zeng,
  • Weidong Song

摘要

Purpose

Autologous osteoperiosteal transplantation (AOPT) from the iliac crest has been proposed as a potential treatment for large osteochondral lesions of the talus (OLTs). This single-arm study aims to prospectively evaluate the clinical, radiological, and arthroscopic outcomes of AOPT from the iliac crest in patients with large cystic OLTs.

Methods

This is a prospective single-arm study. We evaluated 42 patients who underwent AOPT from the iliac crest for OLTs. The mean follow-up was 32.5 months. Clinical outcomes were assessed using the Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) scores, and Tegner activity scores. Radiologic outcomes were evaluated via X-ray, CT, and MRI. Arthroscopy was performed on a subset of patients for second-look evaluation.

Results

Significant clinical improvements were observed, with VAS scores decreasing from 4.36 ± 1.76 to 0.45 ± 0.63, AOFAS scores increasing from 75.38 ± 13.52 to 95.33 ± 4.81, and Tegner scores increasing from 2.00 ± 0.99 to 4.10 ± 1.10. Postoperative imaging revealed the resolution of subchondral radiolucency, improvement of articular surface protrusion or collapse, graft integration with surrounding bone, and a reduction in marrow oedema. Follow-up arthroscopy demonstrated significant lesion repair, with cartilage-like tissue integrated into the talus. No complications, including infections or donor-site morbidity, were observed.

Conclusion

AOPT from the iliac crest is associated with favourable short- to mid-term clinical, radiological, and arthroscopic outcomes, with no complications observed in this series. These findings provide prospective evidence supporting the potential of AOPT from the iliac crest as a treatment option for large talar osteochondral defects.