Donor-Site Morbidity After Osteochondral Autologous Transplantation for Lesions of the Talus

Paul, J.; Sagstetter, A.; Kriner, M.; Imhoff, A. B.; Spang, J.; Hinterwimmer, S.
July 2009
Journal of Bone & Joint Surgery, American Volume;Jul2009, Vol. 91-A Issue 7, p1683
Academic Journal
Background: Autologous osteochondral transplantation is accepted as one of the major treatment options for cartilage defects of the talus. One disadvantage of this technique is the need to harvest a donor graft from a normal knee. The potentially detrimental effect of graft harvest on knee function remains unclear. Methods: Two hundred patients who had transplantation of an autologous osteochondral graft obtained from an asymptomatic knee for the treatment of an osteochondral defect of the talus were evaluated. Of the 200 patients, 112 were followed for a minimum of two years (mean duration of follow-up, fifty-five months). The WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and the Lysholm score were used to assess functional outcome. Variables that were examined included the number of grafts, total size of the harvested cylinders, patient age, body mass index, and overall satisfaction of the patient with the result of the procedure at the knee. A multiple linear regression analysis was utilized to determine the influence of each parameter on the WOMAC and Lysholm scores. In addition, the Lysholm scores for the entire patient group were reviewed to determine how long after the index surgery clinical improvement ceased. Results: The mean postoperative WOMAC score (and standard deviation) for the 112 patients who had been followed for a minimum of two years was 5.5% ± 0.1%, and the mean postoperative Lysholm score was 89 ± 17 points. The number of grafts, the size of the transplanted cylinders, and patient age did not influence either the Lysholm or the WOMAC score. A higher body mass index and lower general satisfaction ratings did negatively influence the Lysholm and WOMAC scores. Gradual clinical improvement, as measured with the Lysholm score for all 200 study subjects, continued throughout the postoperative period. ConcIusions: Donor-site morbidity of a knee from which a graft has been harvested can potentially lead to functional impairment. In our study, the functional outcome of the knee was not affected by the number of donor grafts, the size of the donor grafts, or the age of the patient. Surgeons performing osteochondral transplantations and harvesting autografts from the knee should be aware of the potentially negative effect of a higher body mass index on clinical outcomes after surgery.


Related Articles

  • Opening wedge high tibial osteotomy using 3D biomodelling Bonelike® macroporous structures: case report. Gutierres, M.; Dias, A. G.; Lopes, M. A.; Hussain, N. Sooraj; Cabral, A. T.; Almeida, L.; Santos, J. D. // Journal of Materials Science: Materials in Medicine;Dec2007, Vol. 18 Issue 12, p2377 

    Two synthetic calcium phosphates in porous wedge shape, Bonelike® and a commercial HA/β-TCP biphasic material, were used as an alternative to bone autografts and allografts in the treatment of medial compartment osteoarthritis of varus knees. The structure of Bonelike® has a 3D...

  • Allograft-Prosthetic Composite Reconstruction of the Proximal Part of the Tibia: An Analysis of the Early Results. Gilbert, Nathan F.; Yasko, Alan W.; Oates, Scott D.; Lewis, Valerae O.; Cannon, Christopher P.; Lin, Patrick P. // Journal of Bone & Joint Surgery, American Volume;Jul2009, Vol. 91-A Issue 7, p1646 

    Background: Allograft-prosthetic composite reconstruction of the proximal part of the tibia is one option following resection of a skeletal tumor. Previous studies with use of this technique have found a high prevalence of complications, including fracture, infection, extensor mechanism...

  • Use of non-vascularized autologous fibula strut graft in the treatment of segmental bone loss. Lawal, Y. Z.; Garba, E. S.; Ogirima, M. O.; Dahiru, I. L.; Maitama, M. I.; Abubakar, K.; Ejagwulu, F. S. // Annals of African Medicine;2011, Vol. 10 Issue 1, p25 

    Background: Fractures resulting in segmental bone loss challenge the orthopedic surgeon. Orthopedic surgeons in developed countries have the option of choosing vascularized bone transfers, bone transport, allogenic bone grafts, bone graft substitutes and several other means to treat such...

  • Cubitus varus: problem and solution. Jain, A. K.; Dhammi, I. K.; Arora, A.; Singh, M. P.; Luthra, J. S. // Archives of Orthopaedic & Trauma Surgery;Jul2000, Vol. 120 Issue 7/8, p420 

    A lateral closing wedge osteotomy was performed in 39 children with cubitus varus deformity resulting from a supracondylar fracture. All had a deformity of 15° or more, with 5 having more than 30° of varus. The osteotomy was fixed by three different methods. In 8 cases the osteotomy was...

  • Reconstruction of the anterior cruciate ligament with the iliotibial band autograft in patients with chronic knee instability. Jørgensen, Uffe; Bak, Klaus; Ekstrand, Jan; Scavenius, Michael; Jørgensen, U; Bak, K; Ekstrand, J; Scavenius, M // Knee Surgery, Sports Traumatology, Arthroscopy;May2001, Vol. 9 Issue 3, p137 

    We performed combined internal and external anterior cruciate ligament (ACL) reconstruction with the iliotibial band autograft in 169 consecutive patients with chronic ACL insufficiency who were followed up for 24-61 months. Of these, 155 (91%) agreed to an additional independent observer...

  • A simple and effective technique of femoral tunnel bone grafting in revision anterior cruciate ligament reconstruction. Shetty, Gautam M.; Joon Ho Wang; In Jung Chae; Seung Beom Han // Archives of Orthopaedic & Trauma Surgery;Nov2008, Vol. 128 Issue 11, p1269 

    Restoring the bone stock in the femoral tunnel during revision anterior cruciate ligament reconstruction is vital for better surgical results and to avoid potential complications. The technique must be easy, effective, simple, reproducible and cost effective. We describe a new, simple and...

  • Orthopaedic applications of bone graft & graft substitutes: a review. Nandi, S. K.; Roy, S.; Mukherjee, E; Kundu, B.; De, D. K.; Basu, D. // Indian Journal of Medical Research;Jul2010, Vol. 132 Issue 1, p15 

    Treatment of delayed union, malunion, and nonunion is a challenge to the orthopaedic surgeons in veterinary and human fields. Apart from restoration of alignment and stable fixation, in many cases adjunctive measures such as bone-grafting or use of bone-graft substitutes are of paramount...

  • The Clinical Application and Evaluation of Artificial Cruciate Ligament Materials for Knee Exercise Injury. Zhuo Wang; Yun Peng Han // Advanced Materials Research;2014, Vol. 1022, p64 

    Rupture of knee joint cruciate ligament in sports training and competition, need through the surgical method to reconstruction of ligament reconstruction function. Application of biological materials for cruciate ligament, can make patients get less disease waste, and allows the patient knee...

  • Transplantation of Viable Meniscal Allograft. Verdonk, Peter C. M.; Demurie, Alex; Almqvist, Karl Frederick; Veys, Eric M.; Verbruggen, Gust; Verdonk, René // Journal of Bone & Joint Surgery, American Volume;Mar2006 Supplement 1, Vol. 88-A, p109 

    BACKGROUND: Few medium-term or long-term reports on meniscal allograft transplantations are available. In this study, we present the results of a survival analysis of the clinical outcomes of our first 100 procedures involving transplantation of viable medial and lateral meniscal allografts...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics