Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects : Operative technique.

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects : Operative technique.
Oper Orthop Traumatol. 2020 Sep 09;:
Authors: Kerkhoffs GMMJ, Altink JN, Stufkens SAS, Dahmen J
Abstract
OBJECTIVE: Provision of a natural scaffold, good quality cells, and growth factors in order to facilitate the replacement of the complete osteochondral unit with matching talar curvature for large medial primary and secondary osteochondral defects of the talus.
INDICATIONS: Symptomatic primary and secondary medial osteochondral defects of the talus not responding to conservative treatment; anterior-posterior or medial-lateral diameter >10 mm on computed tomography (CT); closed distal tibial physis in young patients.
CONTRAINDICATIONS: Tibiotalar osteoarthritis grade III; multiple osteochondral defects on the medial, central, and lateral talar dome; malignancy; active infectious ankle joint pathology.
SURGICAL TECHNIQUE: A medial distal tibial osteotomy is performed, after which the osteochondral defect is excised in toto from the talar dome. The recipient site is microdrilled in order to disrupt subchondral bone vessels. Then, the autograft is harvested from the ipsilateral iliac crest with an oscillating saw, after which the graft is adjusted to an exact fitting shape to match the extracted osteochondral defect and the talar morphology as well as curvature. The graft is imp...

Source: Operative Orthopadie und Traumatologie - September 8, 2020 Category: Orthopaedics Authors: Kerkhoffs GMMJ, Altink JN, Stufkens SAS, Dahmen J Tags: Oper Orthop Traumatol Source Type: research