Background: Despite its highly specialized nature, articular
cartilage has a poor reparative capability. Treatment of symptomatic
osteochondral defects of the talus has been especially difficult until
Methods: We performed autologous chondrocyte transplantation in
twelve patients with a focal deep cartilage lesion of the talus. There were
seven female and five male patients with a mean age of 29.7 years. The mean
size of the lesion was 2.3 cm2. All patients were studied
prospectively. Evaluation was performed with use of the Hannover ankle rating
score, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot
score, a visual analogue scale for pain, and magnetic resonance imaging.
Results: All patients were available for follow-up at a mean of
sixty-three months. There was a significant improvement in the Hannover score,
from 40.4 points preoperatively to 85.5 points at the follow-up examination,
with seven excellent results, four good results, and one satisfactory result.
The AOFAS mean score was 88.4 points compared with 43.5 points preoperatively.
Magnetic resonance imaging showed a nearly congruent joint surface in seven
patients, discrete irregularities in four, and an incongruent surface in one.
The patients who had been involved in competitive sports were able to return
to their full activity level.
Conclusions: The promising clinical results of this study suggest
that autologous chondrocyte transplantation is an effective and safe way to
treat symptomatic osteochondral defects of the talus in appropriately selected
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.