Acute cartilage autograft provides low cost, risk for osteochondral lesions of the talus
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WAILEA, Hawaii — Use of acute cartilage autograft may provide a single-stage, low cost and low risk procedure for treatment of osteochondral lesions of the talus, according to a presenter at Orthopedics Today Hawaii.
Eric Giza, MD, noted there are many cell-based regeneration methods that may be used to treat osteochondral lesions of the talus, including autologous chondrocyte implantation, juvenile allografts and matrix autologous chondrocyte implantation (MACI).
“For a while, I was using juvenile allograft and by a while, I mean about 8 years,” Giza said in his presentation.
Although Giza noted juvenile allograft provided good outcomes, it has a cost of $4,000 and insurance does not always cover the cost.
He added MACI is also easy to use, but it has a high cost and is not yet approved for use in the ankle.
“The MACI is neat. You have probably seen it in the knee, but it is not approved for the ankle yet and it costs $40,000,” Giza said.
Giza noted a micronized, dehydrated cartilage matrix can be used to repair osteochondral defects of the talus after microfracture in conjunction with platelet-rich plasma or stem cells. He added the procedure can be performed arthroscopically and at a minimal cost of $750 for the cartilage scaffold and another $300 to $400 for the PRP.
Research into the micronized, dehydrated cartilage matrix by Giza and colleagues revealed the possibility of treating osteochondral lesions of the talus in one step with the use of an autograft instead of an allograft, all for a cost of approximately $2,000, according to Giza.
Giza noted to avoid stiffness after performing the acute cartilage autograft technique, patients should begin range of motion at 2 weeks while remaining non-weight-bearing for 6 weeks.
“They are in a boot and coming out for range of motion from week 2 to week 6, and then out of the boot and usually running by about 6 months,” Giza said.
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Giza E, et al. Talus OCD treatment algorithm – autograft/allograft. Presented at: Orthopedics Today Hawaii 2021; May 30-June 3, 2021; Wailea, Hawaii.
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