Background:

Autologous osteochondral transplantation (AOT) is a treatment option for large or cystic osteochondral lesions of the talus (OLTs), with promising clinical results. However, donor-site morbidity (DSM) has always been a concern with this procedure.

Purpose:

To investigate the clinical and radiological outcomes of autograft harvesting from the medial trochlea for OLTs.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 46 consecutive patients were included after AOT procedures for OLTs, with donor autografts (single or double plugs) harvested from the medial trochlea of the ipsilateral knee. Lysholm scores were collected postoperatively at 12-month intervals to assess clinical outcomes. Postoperative magnetic resonance imaging (MRI) was used to assess the donor site using the MOCART (magnetic resonance observation of cartilage repair tissue) score. DSM was evaluated at 12-month intervals. Statistical analysis was performed to compare patients treated with single-plug and double-plug AOT procedures and establish whether there was any correlation between MOCART and Lysholm scores.

Results:

The mean follow-up period was 98.3 months (range, 67-144 months). The Lysholm scores for all patients were 92.5 ± 6.1 and 99.9 ± 0.2 at the 12-month and final follow-ups, respectively. MRI of the donor sites was taken at an average of 93.8 ± 20.5 (range, 61-141) months postoperatively, and the mean MOCART score was 76.2 ± 4.9. The overall incidence of DSM in this study was 4.3% at 12 months, postoperatively, which decreased to 0% at the 24-month follow-up. There was no significant difference in either the Lysholm score (P = .16) or the MOCART score (P = .83) between the single-plug and double-plug groups at the final follow-up. There were no significant correlations between MOCART and Lysholm scores and patient age, number of grafts, or body mass index.

Conclusion:

According to the study findings, the DSM of donor autografts harvested from the medial trochlea was low, and the number (single or double) of grafts did not affect the functional outcome.

中文翻译：

---

从内侧滑车采集自体移植物治疗距骨骨软骨损伤后的临床和 MRI 供体部位结果：至少 5 年临床随访

 背景：

自体骨软骨移植（AOT）是距骨大块或囊性骨软骨病变（OLT）的一种治疗选择，具有良好的临床效果。然而，供体部位发病率 (DSM) 一直是该手术的一个问题。

 目的：

研究从 OLT 内侧滑车采集自体移植物的临床和放射学结果。

 研究设计：

案例系列；证据级别，4。

 方法：

在 OLT 的 AOT 手术后，总共纳入了 46 名连续患者，其中供体自体移植物（单塞或双塞）从同侧膝关节内侧滑车获取。术后每隔 12 个月收集一次 Lysholm 评分以评估临床结果。术后磁共振成像（MRI）用于使用MOCART（软骨修复组织磁共振观察）评分来评估供体部位。 DSM 每 12 个月进行一次评估。进行统计分析以比较接受单插头和双插头 AOT 手术治疗的患者，并确定 MOCART 和 Lysholm 评分之间是否存在相关性。

 结果：

平均随访期为 98.3 个月（范围：67-144 个月）。所有患者在 12 个月和最终随访时的 Lysholm 评分分别为 92.5 ± 6.1 和 99.9 ± 0.2。术后平均 93.8 ± 20.5（范围，61-141）个月对供体部位进行 MRI 检查，平均 MOCART 评分为 76.2 ± 4.9。本研究中术后 12 个月时 DSM 的总体发生率为 4.3%，在 24 个月的随访中降至 0%。最终随访时，单插头组和双插头组之间的 Lysholm 评分 ( P = .16) 或 MOCART 评分 ( P = .83) 没有显着差异。 MOCART 和 Lysholm 评分与患者年龄、移植物数量或体重指数之间没有显着相关性。

 结论：

根据研究结果，从内侧滑车获取的供体自体移植物的 DSM 较低，并且移植物的数量（单个或双）不影响功能结果。