Treatment of an osteochondral lesions of the talus with a novel patient-specific metallic implant: A case report with 5-year follow-up and review of the literature

Abstract

Osteochondral lesions of the talus are a relevant cause of pain and disability while their treatment remain challenging. If conservative treatments fail, surgical interventions such as core decompression, microfracturing of the talus or osteochondral treatments can be performed. As already described for the knee joint, there are also novel patient-specific implants for the treatment of focal osteochondral defects. For the first time such implant technology was used in the ankle joint. We report a 33-year-old male patient with persistent pain and reduced range of motion following an ankle sprain. He was referred after initial conservative treatment and an osteochondral autograft transplant. An MRI was performed to identify the location and dimension of the medial talar cystic defect with a length of 15 mm and a width of 7 mm. Using this data, a patient-specific implant and guiding instruments were manufactured for this surgery. Postoperatively, the patient reported reduced pain and improvements in clinical outcomes (range of motion) as well as in subjective scores Foot and Ankle Ability Measure (sports subscale), Foot Function Index, Visual Analogous Scale pain, Foot and Ankle Outcome Score and Healthy score were recorded preoperatively and at follow-ups up to 5 years. The patient returned to his former job as a car mechanic and plays soccer up to three times a week. In the presented case, the first implantation of a novel patient-specific metallic implant for the treatment of focal osteochondral lesion of the talus has been highly successful up to five years after implantation.

Keywords

• 4