Study Comparing Two Types of Autologous Transplantation for Treating Severe Talar Osteochondral Lesions in Adults

What this Trial Is About

Researchers are evaluating the effectiveness and safety of autologous costal osteochondral transplantation compared with autologous osteoperiosteal transplantation in treating Hepple Stage V talar osteochondral lesions. The main goal is to determine if the costal osteochondral transplantation can provide better clinical outcomes and improved cartilage repair with fewer donor site complications than the osteoperiosteal transplantation. Participants will be randomly assigned to one of these two surgical treatments. The study involves two treatment groups one receiving the autologous costal osteochondral transplantation, which includes harvesting an osteochondral column from the rib and implanting it into the talar defect, and the other receiving autologous iliac osteoperiosteal transplantation, which involves obtaining a cylindrical osteoperiosteal column from the iliac crest for implantation. Both surgeries include removing the talar lesion, filling the cavity with cancellous bone, and ensuring the transplant surface aligns with the surrounding cartilage. After surgery, all participants will follow the same rehabilitation and follow-up plan. Participants will be monitored over time with various assessments including the American Orthopedic Foot and Ankle Society AOFAS ankle-hindfoot scale at multiple intervals up to 24 months after surgery. Additional measures include pain ratings during walking, cartilage repair evaluations by MRI, functional scores, bone healing, patient satisfaction, and monitoring for any complications. The study aims to collect detailed data on clinical outcomes and safety over two years following the surgical treatment.

Autologous Costal Osteochondral Transplantation for Talar Osteochondral Lesions