Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus
Abstract Background Surgical management methods for Hepple IV-V osteochondral lesions of the talus (OLT) are diverse. This study aimed to compare the clinical efficacy of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone gr...
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BMC
2025-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-05468-x |
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| author | Xinyu Tang Xinkun Han Haitao Fu Youliang Shen Dongfang Zhang Qinwei Guo Chao Qi |
| author_facet | Xinyu Tang Xinkun Han Haitao Fu Youliang Shen Dongfang Zhang Qinwei Guo Chao Qi |
| author_sort | Xinyu Tang |
| collection | DOAJ |
| description | Abstract Background Surgical management methods for Hepple IV-V osteochondral lesions of the talus (OLT) are diverse. This study aimed to compare the clinical efficacy of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting in the treatment of medial Hepple IV-V OLT. Methods A retrospective analysis of clinical data from patients who underwent surgical treatment for Hepple IV-V OLT (2020–2023) was conducted. A total of 37 patients were included, with 17 receiving arthroscopic autologous cancellous bone grafting (Group A) and 20 receiving medial malleolar osteotomy combined with autologous periosteal iliac bone grafting (Group B). Compared the surgical time of the two groups; the visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and ankle joint mobility were used preoperatively, and at 3 months and 1 year postoperatively to assess clinical efficacy; the magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 ankle scores were evaluated at early postoperatively and 1 year postoperatively to assess cartilage repair. Results The surgical time for Group A was significantly shorter than Group B (P < 0.05). At 3 months and 1 year postoperatively, both groups showed a significant improvements in VAS scores, AOFAS scores, and ankle joint mobility compared to preoperative levels (P < 0.05). At 3 months postoperatively, Group A had significantly higher AOFAS scores and ankle joint mobility than Group B (P < 0.05), while there was no statistically significant difference in VAS scores between the two groups (P > 0.05). At 1 year postoperatively, no significant differences in any of the assessed parameters were found between the two groups (P > 0.05). The MOCART 2.0 ankle scores at 1 year postoperatively were significantly higher than early postoperatively for both groups (P < 0.05), with no significant differences between the two groups (P > 0.05). Conclusion Arthroscopic autologous cancellous bone grafting showed superior early functional recovery at the 3-month follow-up compared to medial malleolar osteotomy combined with autologous periosteal iliac bone grafting, with shorter surgical time and avoiding osteotomy. Both surgical methods were able to relieve patients’ pain, restore function, and improve cartilage repair. Level of evidence III, retrospective comparative study. |
| format | Article |
| id | doaj-art-31508cebe14e4bfba80f79a8d2c4504a |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-31508cebe14e4bfba80f79a8d2c4504a2025-01-19T12:32:40ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111110.1186/s13018-025-05468-xComparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talusXinyu Tang0Xinkun Han1Haitao Fu2Youliang Shen3Dongfang Zhang4Qinwei Guo5Chao Qi6Department of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao UniversityDepartment of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao UniversityDepartment of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao UniversityDepartment of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao UniversityDepartment of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao UniversityDepartment of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking UniversityDepartment of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao UniversityAbstract Background Surgical management methods for Hepple IV-V osteochondral lesions of the talus (OLT) are diverse. This study aimed to compare the clinical efficacy of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting in the treatment of medial Hepple IV-V OLT. Methods A retrospective analysis of clinical data from patients who underwent surgical treatment for Hepple IV-V OLT (2020–2023) was conducted. A total of 37 patients were included, with 17 receiving arthroscopic autologous cancellous bone grafting (Group A) and 20 receiving medial malleolar osteotomy combined with autologous periosteal iliac bone grafting (Group B). Compared the surgical time of the two groups; the visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and ankle joint mobility were used preoperatively, and at 3 months and 1 year postoperatively to assess clinical efficacy; the magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 ankle scores were evaluated at early postoperatively and 1 year postoperatively to assess cartilage repair. Results The surgical time for Group A was significantly shorter than Group B (P < 0.05). At 3 months and 1 year postoperatively, both groups showed a significant improvements in VAS scores, AOFAS scores, and ankle joint mobility compared to preoperative levels (P < 0.05). At 3 months postoperatively, Group A had significantly higher AOFAS scores and ankle joint mobility than Group B (P < 0.05), while there was no statistically significant difference in VAS scores between the two groups (P > 0.05). At 1 year postoperatively, no significant differences in any of the assessed parameters were found between the two groups (P > 0.05). The MOCART 2.0 ankle scores at 1 year postoperatively were significantly higher than early postoperatively for both groups (P < 0.05), with no significant differences between the two groups (P > 0.05). Conclusion Arthroscopic autologous cancellous bone grafting showed superior early functional recovery at the 3-month follow-up compared to medial malleolar osteotomy combined with autologous periosteal iliac bone grafting, with shorter surgical time and avoiding osteotomy. Both surgical methods were able to relieve patients’ pain, restore function, and improve cartilage repair. Level of evidence III, retrospective comparative study.https://doi.org/10.1186/s13018-025-05468-xOsteochondral lesions of the talusAnkle arthroscopyAutologous cancellous bone graftingMedial malleolar osteotomyAutologous periosteal iliac bone transplantationComparative clinical efficacy |
| spellingShingle | Xinyu Tang Xinkun Han Haitao Fu Youliang Shen Dongfang Zhang Qinwei Guo Chao Qi Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus Journal of Orthopaedic Surgery and Research Osteochondral lesions of the talus Ankle arthroscopy Autologous cancellous bone grafting Medial malleolar osteotomy Autologous periosteal iliac bone transplantation Comparative clinical efficacy |
| title | Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus |
| title_full | Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus |
| title_fullStr | Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus |
| title_full_unstemmed | Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus |
| title_short | Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus |
| title_sort | comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus |
| topic | Osteochondral lesions of the talus Ankle arthroscopy Autologous cancellous bone grafting Medial malleolar osteotomy Autologous periosteal iliac bone transplantation Comparative clinical efficacy |
| url | https://doi.org/10.1186/s13018-025-05468-x |
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