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Tan EW, Finney FT, Maccario C, et al. Histological and Gross Evaluation through Second-Look Arthroscopy of Osteochondral Lesions of the Talus after Failed Treatment with Particulated Juvenile Cartilage: A Case Series. J Orthop Case Rep. 2018;8(2):69-73doi: 10.13107/jocr.2250-0685.1056.
Tan, E. W., Finney, F. T., Maccario, C., Talusan, P. G., Zhang, Z., & Schon, L. C. (2018). Histological and Gross Evaluation through Second-Look Arthroscopy of Osteochondral Lesions of the Talus after Failed Treatment with Particulated Juvenile Cartilage: A Case Series. Journal of orthopaedic case reports, 8(2), 69-73. https://doi.org/10.13107/jocr.2250-0685.1056
Tan, Eric W, et al. "Histological and Gross Evaluation through Second-Look Arthroscopy of Osteochondral Lesions of the Talus after Failed Treatment with Particulated Juvenile Cartilage: A Case Series." Journal of orthopaedic case reports vol. 8,2 (2018): 69-73. doi: https://doi.org/10.13107/jocr.2250-0685.1056
Tan EW, Finney FT, Maccario C, Talusan PG, Zhang Z, Schon LC. Histological and Gross Evaluation through Second-Look Arthroscopy of Osteochondral Lesions of the Talus after Failed Treatment with Particulated Juvenile Cartilage: A Case Series. J Orthop Case Rep. 2018 Mar-Apr;8(2):69-73. doi: 10.13107/jocr.2250-0685.1056. PMID: 30167418; PMCID: PMC6114197.
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J Orthop Case Rep. 2018 Mar-Apr;8(2):69-73. doi: 10.13107/jocr.2250-0685.1056.

Histological and Gross Evaluation through Second-Look Arthroscopy of Osteochondral Lesions of the Talus after Failed Treatment with Particulated Juvenile Cartilage: A Case Series.

Journal of orthopaedic case reports

Eric W Tan, Fred T Finney, Camilla Maccario, Paul G Talusan, Zijun Zhang, Lew C Schon

Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  2. Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
  3. Department of Orthopaedic Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
  4. C.A.S.C.O. Foot and Ankle Unit - IRCCS Galeazzi, Universita' degli Studi di Milano, Milano, Italy.

PMID: 30167418 PMCID: PMC6114197 DOI: 10.13107/jocr.2250-0685.1056

Abstract

INTRODUCTION: The treatment of osteochondral lesions of the talus (OLTs) recalcitrant to non-surgical interventions is challenging. Particulated juvenile cartilage allograft transplantation (PJCAT) has become a viable treatment option, obviating the need for an osteotomy or second-stage surgery and eliminating risk of donor site morbidity. Short-term outcomes have been promising, but failures associated with PJCAT have not been well described.

CASE REPORT: Four patients with OLTs who had continued symptoms after PJCAT underwent a second-look arthroscopic evaluation. The quality of cartilage repair was evaluated using the international cartilage repair society (ICRS) score. Biopsy of the repair was taken for histological analysis. Two patients demonstrated a lack of integration of the allograft into the surrounding cartilage, and two had failures associated with impingement. Three patients' repairs were consistent with a Grade III ICRS score and one with a Grade II score. Histological examination demonstrated fibrotic repair tissue (Type 1 collagen) with depleted proteoglycans and Type II collagen.

CONCLUSION: There were no obvious patients or surgical factors associated with poor outcomes. Integration of PJCAT with surrounding cartilage appears to be affected by biological and mechanical factors. Further, understanding of factors influencing PJCAT integration will help develop more specific indications for use.

Keywords: Ankle; DeNovo®; NT Graft; articular cartilage; juvenile allograft; particulated cartilage

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