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Meta-Analysis
. 2021 May;29(5):1554-1561.
doi: 10.1007/s00167-020-06216-w. Epub 2020 Aug 28.

Autologous osteochondral transplantation for osteochondral lesions of the talus: high rate of return to play in the athletic population

Dexter Seow  1 , Yoshiharu Shimozono  1 , Arianna L Gianakos  2 , Eugenio Chiarello  3 , Nathaniel Mercer  1 , Eoghan T Hurley  1 , John G Kennedy  4
Affiliations
Meta-Analysis

Autologous osteochondral transplantation for osteochondral lesions of the talus: high rate of return to play in the athletic population

Dexter Seow et al. Knee Surg Sports Traumatol Arthrosc. 2021 May.

Abstract

Purpose: (1) To determine the rate of return to play following autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus (OLT) and (2) report subsequent rehabilitation protocols.

Methods: A systematic review of the PubMed, Embase, and The Cochrane Library databases was performed according to the PRISMA guidelines based on specific eligibility criteria. Return to play data was meta-analysed and subsequent rehabilitation protocols were summarised. Level of evidence and quality of evidence (Zaman's criteria) were also evaluated.

Results: Nine studies that totalled 205 ankles were included for review. The mean follow-up was 44.4 ± 25.0 (range 16-84) months. The mean OLT size was 135.4 ± 56.4 mm2. The mean time to return to play was 5.8 ± 2.6 months. The mean rate of return to play was 86.3% (range 50-95.2%), with 81.8% of athletes returning to pre-injury status. Based on the fixed-effect model, the rate of return to play was 84.07%. Significant correlation was found between increase age and decrease rate of return to play (R2 = 0.362, p = 0.00056). There was no correlation between OLT sizes and rate of return to play (R2 = 0.140, p = 0.023). The most common time to ankle motion post-surgery was immediately and the most common time to full weight-bearing was 12 weeks.

Conclusions: This systematic review indicated a high rate of return to play following AOT in the athletic population. Size of OLT was not found to be a predictor of return to play, whereas advancing age was a predictor. Rehabilitation protocols were largely inconsistent and were primarily based on individual surgeon protocols. However, the included studies were of low level and quality of evidence.

Level of evidence: Level IV.

Keywords: Autograft; Osteochondral lesion; Rehabilitation protocol; Return to sport; Talus.

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