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Objectives <p>To analyze the feasibility, effectiveness and safety of autologous costochondral transplantation (ACT) in patients with Hepple V osteochondral lesion of talus (OLT), and to analyze the short-to-intermediate-term efficacy.</p> Methods <p>Clinical data of 27 patients (27 ankles) with Hepple V OLT admitted in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital between February 2020 and February 2022 were retrospectively analyzed, of which were treated with ACT. The general information, operation time, and hospitalization days of the patients were recorded. According to the foot and ankle ability measurement (FAAM)–activities of daily living subscale (FAAM–ADL) and sports subscale (FAAM-Sp), the EuroQol-Visual Analogue Scale (EQ VAS) and the Magnetic Resonance Observation of Cartilage Repair Tissue 2.0 ankle score (MOCART 2.0), surgical efficacy and of the patients’ function were evaluated, to verify the clinical satisfaction of ACT. The related complications that occurred during the follow-up of the patients in the group were also recorded. Statistical analysis included normality assessment, intra-group comparisons (one-way analysis of variance (ANOVA) and LSD method for normal quantitative data, Mann–Whitney <i>U</i> for non-normal data, and chi-square for categorical variables). <i>P</i> &lt; 0.05 was considered a statistically significant difference.</p> Results <p>All patients were operated successfully. The general information, operation time, and hospitalization days of the patients were fully recorded. At the final follow-up, scores of FAAM–ADL, FAAM-Sp and EQ VAS were improved to 87.7 ± 6.8 (P &lt; 0.001), 87.2 ± 7.4 (P &lt; 0.001), 90.7 ± 3.3 (<i>P</i> &lt; 0.001) from preoperative ones, respectively. MOCART 2.0 scores improved from 85(80, 90) 12 months postoperatively&#xa0;to 85(85, 90) at final follow-up (<i>P </i>= 0.025). Three patients (11.1%) voluntarily removed the internal fixation of the internal ankle osteotomy. There were no complications, such as neurovascular injury, nonunion or delayed union, and post-traumatic arthritis in both groups.</p> Conclusion <p>This study preliminarily validated that ACT could restore the defective talar articular cartilage shorten the operation time and hospitalization days, reduce the amount of intraoperative blood loss, achieve excellent outcomes and help patients return to work and recreational activities more quickly.</p>

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Analysis of the short-to-intermediate-term efficacy of autologous costochondral transplantation in treatment for Hepple V osteochondral lesion of talus

  • 期刊论文

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  • 发表日期：

    2025年8月21日

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  • Jiazheng Wang,
  • Jieyuan Zhang,
  • Shaolin Fu,
  • Xueqian Li,
  • Cheng Wang,
  • Chenglin Wu,
  • Shutao Zhang,
  • Xin Ma,
  • Zhongmin Shi

摘要

Objectives

To analyze the feasibility, effectiveness and safety of autologous costochondral transplantation (ACT) in patients with Hepple V osteochondral lesion of talus (OLT), and to analyze the short-to-intermediate-term efficacy.

Methods

Clinical data of 27 patients (27 ankles) with Hepple V OLT admitted in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital between February 2020 and February 2022 were retrospectively analyzed, of which were treated with ACT. The general information, operation time, and hospitalization days of the patients were recorded. According to the foot and ankle ability measurement (FAAM)–activities of daily living subscale (FAAM–ADL) and sports subscale (FAAM-Sp), the EuroQol-Visual Analogue Scale (EQ VAS) and the Magnetic Resonance Observation of Cartilage Repair Tissue 2.0 ankle score (MOCART 2.0), surgical efficacy and of the patients’ function were evaluated, to verify the clinical satisfaction of ACT. The related complications that occurred during the follow-up of the patients in the group were also recorded. Statistical analysis included normality assessment, intra-group comparisons (one-way analysis of variance (ANOVA) and LSD method for normal quantitative data, Mann–Whitney U for non-normal data, and chi-square for categorical variables). P < 0.05 was considered a statistically significant difference.

Results

All patients were operated successfully. The general information, operation time, and hospitalization days of the patients were fully recorded. At the final follow-up, scores of FAAM–ADL, FAAM-Sp and EQ VAS were improved to 87.7 ± 6.8 (P < 0.001), 87.2 ± 7.4 (P < 0.001), 90.7 ± 3.3 (P < 0.001) from preoperative ones, respectively. MOCART 2.0 scores improved from 85(80, 90) 12 months postoperatively to 85(85, 90) at final follow-up (P = 0.025). Three patients (11.1%) voluntarily removed the internal fixation of the internal ankle osteotomy. There were no complications, such as neurovascular injury, nonunion or delayed union, and post-traumatic arthritis in both groups.

Conclusion

This study preliminarily validated that ACT could restore the defective talar articular cartilage shorten the operation time and hospitalization days, reduce the amount of intraoperative blood loss, achieve excellent outcomes and help patients return to work and recreational activities more quickly.