Autologous osteochondral transplantation for osteochondral lesions of the talus in an athletic population

To assess clinical outcomes and return to sport in an athletic population treated with autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus. A total of 36 patients were included in this retrospective study including 21 professional athletes and 15 amateur athletes who participated in regular moderate- or high-impact athletic activity. All patients underwent autologous osteochondral transplantation of the talus under the care of a single surgeon. At a mean follow-up of 5.9 years, patients were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system. All patients also received pre-operative MRI with the follow-up MRI performed at 1 year and underwent assessment of return to athletic activity. The overall AOFAS score improved from 65.5 (SD +/- A 11.1) to 89.4 (SD +/- A 14.4) (p = 0.01). At a final follow-up, 90 % of professional athletes (19 of 21) were still competing in athletic activity or still able to participate in unrestricted activity. Of the recreational athletes, 87 % (13 of 15) had full return to pre-injury activity levels, while two (13 %) returned to activity with restrictions or reduced intensity. MRI showed cystic change in 33 % of patients post-operatively; however, this did not appear to affect outcomes (n.s.). Donor site symptoms were seen in 11 % of the cohort at final follow-up, despite high function at donor knee. The results of our study indicate that AOT procedure is able to achieve good outcomes in an athletic population at a midterm follow-up. Retrospective case series, Level IV.