Paper 69: Do Patients Participate in Sports or Recreational Activity After Osteochondral Allograft Transplantation of the Talus?

OBJECTIVES: Fresh osteochondral allograft (OCA) transplantation has been reported as a viable treatment option for chondral lesions of the talus, but there is insufficient data regarding patients’ participation in sports or recreational activity following the procedure. The purpose of this study was to assess the frequency of patients who participated in sports or recreational activity following OCA of the talus. METHODS: We identified 36 ankles in 34 patients (70% well trained or highly competitive athletes) who underwent OCA transplantation of the talus. Mean age was 36 years and 50% were male. Postoperatively, participation in sport or recreational activity, foot and ankle ability measure (FAAM) scores, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores, and patient satisfaction with the results of surgery were assessed. Further surgery on the ankle was captured, and OCA failure was defined as any operation that involved removal of the allograft. RESULTS: At a mean follow up of 8.6 years, 67% of patients reported that they had participated in sports or recreational activity after the OCA transplantation. Among those who participated in sport or recreation, 68% returned to their pre-injury sport, 21% played in competitive sports, and 95% participated in regular exercise. Following the OCA transplantation, 17% of ankles required further surgery and 11% were classified as OCA failures (underwent revision OCA transplantation or fusion). There was significant improvement in FAAM and AOFAS ankle-hindfoot scores, and 79% of patients were either satisfied or extremely satisfied with the results of surgery. Survivorship of the OCA transplantation was 94% at five years and 85% at ten years. CONCLUSIONS: Fresh OCA transplantation is a reasonable surgical option for osteochondral defects of the talus for young, active patients who have failed non-operative management. Most patients participate in sports or recreational activity following OCA transplantation of the talus.