2021 ISAKOS Biennial Congress Paper
Long-Term Outcome Measures Following Particulated Juvenile Allograft Cartilage Implantation For Treatment Of Difficult Osteochondral Lesions Of The Talus
Cary Chapman, MD, Plantation , FL UNITED STATES
Joseph Manzi, BA, New York, NY UNITED STATES
Mathew Hamula, MD, New York, NY UNITED STATES
Dinesh Dhanaraj, MD, MSPH, Langhorne , PA UNITED STATES
Miami Orthopedics & Sports Medicine Institute, Coral Gables, FL, UNITED STATES
FDA Status Cleared
Particulated juvenile allograft articular cartiage demonstrates overall good clinical results at long term follow up (6-8 years)
Patients with symptomatic osteochondral lesions of the talus can have serious impairments in their activities of daily living and occupations. The role of particulated juvenile allograft articular cartilage (DeNovo NT®) implantation is not well elucidated in reference to long-term patient outcomes.
A total of thirteen patients with difficult to treat osteochondral lesions of the talus underwent arthroscopic assisted implantation of DeNovo NT® graft into defects from 2010-2012 by the same surgeon. Difficult lesions were defined as having some combination of the following: 1) lesions size of 1.07cm2 or greater, 2) corner/shoulder lesions, 3) patients who failed microfracture, 4) patient age over 40, or 5) patient BMI>25kg/m2. Patients were evaluated using physical examination, patient interviews, and pre and postoperative outcome score measures. Patients had follow-up at 2 years, 4 years, and between 6-9 years at their most recent follow-up. Differences in functional outcome scores were compared before and after surgery.
Patients (Age: 46.5±11.8years; Sex: 8 Male/5 Female; Body Mass Index: 28.5 ±6.1kg/m2) had on average, most recent follow-up of 8.0 years (range 72-113 months). Average VAS pain score decreased for patients by 3.9 points, 95% CI [2.18, 5.60], when compared to preoperative assessment. FAAM ADL and Sports scores also showed improvement from 46.5 to 80.9, 95% CI [21.35, 47.43] and from 18.8 to 57.9, 95% CI [21.05, 57.10], respectively. SF-36 physical component scores showed significant improvement by an average of 45.5 points, 95% CI [32.42, 58.50]. AOFAS scores improved from 55.2 to 80.3, 95% CI [12.459, 37.741].
The use of arthroscopic assisted DeNovo NT® implantation of talar osteochondral lesions provides satisfactory outcomes for difficult to treat lesions. These results demonstrate clinically positive long-term outcomes for a cohort of patients followed over the course of 6-9 years.