Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Aug 25;3(4):e533-7.
doi: 10.1016/j.eats.2014.06.004. eCollection 2014 Aug.

Arthroscopic Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus

Samuel B Adams Jr  1 , Constantine A Demetracopoulos  2 , Selene G Parekh  1 , Mark E Easley  1 , Justin Robbins  1
Affiliations

Arthroscopic Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus

Samuel B Adams Jr et al. Arthrosc Tech. .

Abstract

Several options exist for the treatment of osteochondral lesions of the talus. Particulated juvenile cartilage allograft transplantation (PJCAT) has become a viable treatment modality for osteochondral lesions of the talus that are not amenable to microfracture or for which microfracture has failed. Arthroscopic placement of this type of graft obviates the need for osteotomy or plafondplasty and does not prevent additional procedures from being performed through an anterior approach. Special instrumentation and setup are not required to perform this procedure. Our arthroscopic technique for placement of particulated juvenile cartilage into osteochondral lesions of the talus is described. Case series and outcomes after arthroscopic ankle PJCAT are currently not reported within the literature; however, it is believed that the outcomes are at least similar to those of open ankle PJCAT.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Right ankle with anterolateral OLT (viewed through medial portal).
Fig 2
Fig 2
Lesion preparation with ringed curette (viewed through medial portal). The curette is in the lateral portal.
Fig 3
Fig 3
Final lesion preparation (viewed through medial portal). Fluid has been evacuated from the joint. The distal fibula exposure, indicating that this is a shoulder lesion, should be noted.
Fig 4
Fig 4
Drying lesion base with Weck-Cel sponge (viewed through medial portal).
Fig 5
Fig 5
Delivery of graft through lateral portal (viewed through medial portal). One should note that the bevel of the trocar is facing toward the lesion.
Fig 6
Fig 6
Application of fibrin to graft (viewed through medial portal).
Fig 7
Fig 7
Graft distributed throughout lesion using a freer (viewed through medial portal).
Fig 8
Fig 8
Additional fibrin is added once all the DeNovo graft has been implanted (viewed through medial portal).
Fig 9
Fig 9
Final view of grafted defect (viewed through medial portal).
See this image and copyright information in PMC

References

    1. Giurea A., DiMicco M.A., Akeson W.H., Sah R.L. Development-associated differences in integrative cartilage repair: Roles of biosynthesis and matrix. J Orthop Res. 2002;20:1274–1281. - PubMed
    1. Hunziker E.B., Kapfinger E., Müller M.E. Removal of proteoglycans from the surface of defects in articular cartilage transiently enhances coverage by repair cells. J Bone Joint Surg Br. 1998;80:144–150. - PubMed
    1. Qiu W., Murray M.M., Shortkroff S., Lee C.R., Martin S.D., Spector M. Outgrowth of chondrocytes from human articular cartilage explants and expression of α-smooth muscle actin. Wound Repair Regen. 2000;8:383–391. - PubMed
    1. Nehrer S., Spector M., Minas T. Histologic analysis of tissue after failed cartilage repair procedures. Clin Orthop Relat Res. 1999;365:149–162. - PubMed
    1. McGahan P.J., Pinney S.J. Current concept review: Osteochondral lesions of the talus. Foot Ankle Int. 2010;31:90–101. - PubMed

LinkOut - more resources