Talar Osteoperiostic Grafting from the Iliac Crest (TOPIC): Return to Sports Outcomes of A Novel Press-Fit Surgical Treatment for Large Talar Osteochondral Lesions

CATEGORY: Ankle INTRODUCTION/PURPOSE: The purpose of this study was to evaluate the sports outcomes of a new press-fit OATS technique for large primary and secondary talar osteochondral lesions of the talus (OLTs), Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC). METHODS: The study population included amateur and professional athletes with a talar osteochondral lesion size of at least 10 mm in diameter as measured anteroposteriorly or mediolaterally. The surgical intervention in question was the Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) procedure, which was performed in a press-fit way. Sports outcomes at a minimum of 24 months included return to sports rates, level (return to any level of sports, return to pre-injury levels of sports, and return to performance), including corresponding return to sports times of the aforementioned levels. RESULTS: A total of 30 athletes, including 1 professional athlete, were assessed. All patients were available for the follow-up at 24 months post-operatively. The mean follow-up duration was 24 months (SD 4.5). The mean lesion size was 356 mm(2). Return to any level of sports rate was 90% (95% CI 83 - 95) with an associated time of 8.4 months (SD 2.3). Return to pre-injury level of sports rate was 72% (95% CI 60 - 83) with an associated time of 9.5 months (SD 3.0). Return to performance was 30% (95% CI 20 - 40) with an associated return to performance time of 12 months (SD 4.6). CONCLUSION: Our study suggests that a TOPIC procedure can be considered a good option in the management of large osteochondral lesions of the talar dome in an active sports population, with adequate return to sports and work outcomes. Further research is required to optimize our surgical technique and show long-term outcomes.