TY - JOUR
T1 - Magnetic Resonance Imaging Evidence of Postoperative Cyst Formation Does Not Appear to Affect Clinical Outcomes After Autologous Osteochondral Transplantation of the Talus
AU - Savage-Elliott, Ian
AU - Smyth, Niall A.
AU - Deyer, Timothy W.
AU - Murawski, Christopher D.
AU - Ross, Keir A.
AU - Hannon, Charles P.
AU - Do, Huong T.
AU - Kennedy, John G.
N1 - Funding Information:
The authors report the following potential conflict of interest or source of funding: C.D.M. is one of the board of directors and is an executive director in the International Society on Cartilage Repair of the Ankle, both unpaid. J.G.K. receives support from Ateriocyte, Biomet, Stryker, and Ohnell Family Foundation, Mr. and Mrs. Michael J. Levitt (industry and philanthropic grants for research given directly to Hospital for Special Surgery). J.G.K. is one of the board of directors and is an executive director in the International Society on Cartilage Repair of the Ankle, both unpaid.
Publisher Copyright:
© 2016 Arthroscopy Association of North America
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Purpose To identify potential cysts using magnetic resonance imaging (MRI) after autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus (OLTs) as well as to determine the effect of cysts on short-term clinical outcomes. Methods Eighty-nine MRI scans of 37 patients who had AOT for an OLT were evaluated. Radiographic variables examined included cyst presence, cyst location, bone edema, and cartilage integrity. Patient clinical variables recorded and examined for association with the presence of a cyst included gender, age, preoperative lesion size, size and number of osteochondral graft used, symptoms reported, and pre- and postoperative Foot and Ankle Outcome Score (FAOS) and Short Form-12 (SF-12) scores measured at final follow-up. Results Twenty-four patients (64.8%) had MRI evidence of cystic change after AOT for an OLT at a mean MRI follow-up time of 15 months after surgery (range 2-54). Patients with presence of a cyst after surgery were older (mean age, 42.7 years) than those without cysts (mean age, 32.7 years) (P =.041), and among patients with a cyst, older patients more often had involvement of the subchondral plate (57.3 v 36.7 years) (P <.001). No other variables associated with cyst formation had statistical significance. Mean patient FAOS scores increased from 50 (±19) preoperatively to 87 (±8) postoperatively. Mean SF-12 scores increased from 52 (±18) preoperatively to 85 (±6) postoperatively. Patients not identified as having a cyst had lower SF-12 (P = .028) and FAOS (P =.032) preoperative scores and more improvement in SF-12 (P =.006) and FAOS (P = .016) scores than patients with cysts. Conclusions Postoperative cyst formation on MRI was found to be a common occurrence after AOT for OLT. Although increasing age was related to increased cyst prevalence, the clinical impact of cyst formation was not found to be significant at short-term follow-up. Continued long-term longitudinal follow-up of postoperative cysts is needed. Level of Evidence Level IV, prognostic case series.
AB - Purpose To identify potential cysts using magnetic resonance imaging (MRI) after autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus (OLTs) as well as to determine the effect of cysts on short-term clinical outcomes. Methods Eighty-nine MRI scans of 37 patients who had AOT for an OLT were evaluated. Radiographic variables examined included cyst presence, cyst location, bone edema, and cartilage integrity. Patient clinical variables recorded and examined for association with the presence of a cyst included gender, age, preoperative lesion size, size and number of osteochondral graft used, symptoms reported, and pre- and postoperative Foot and Ankle Outcome Score (FAOS) and Short Form-12 (SF-12) scores measured at final follow-up. Results Twenty-four patients (64.8%) had MRI evidence of cystic change after AOT for an OLT at a mean MRI follow-up time of 15 months after surgery (range 2-54). Patients with presence of a cyst after surgery were older (mean age, 42.7 years) than those without cysts (mean age, 32.7 years) (P =.041), and among patients with a cyst, older patients more often had involvement of the subchondral plate (57.3 v 36.7 years) (P <.001). No other variables associated with cyst formation had statistical significance. Mean patient FAOS scores increased from 50 (±19) preoperatively to 87 (±8) postoperatively. Mean SF-12 scores increased from 52 (±18) preoperatively to 85 (±6) postoperatively. Patients not identified as having a cyst had lower SF-12 (P = .028) and FAOS (P =.032) preoperative scores and more improvement in SF-12 (P =.006) and FAOS (P = .016) scores than patients with cysts. Conclusions Postoperative cyst formation on MRI was found to be a common occurrence after AOT for OLT. Although increasing age was related to increased cyst prevalence, the clinical impact of cyst formation was not found to be significant at short-term follow-up. Continued long-term longitudinal follow-up of postoperative cysts is needed. Level of Evidence Level IV, prognostic case series.
UR - http://www.scopus.com/inward/record.url?scp=84990950550&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2016.04.018
DO - 10.1016/j.arthro.2016.04.018
M3 - Article
C2 - 27453454
AN - SCOPUS:84990950550
VL - 32
SP - 1846
EP - 1854
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
SN - 0749-8063
IS - 9
ER -