J Shanghai Jiaotong Univ Sci ›› 2021, Vol. 26 ›› Issue (3): 346-351.doi: 10.1007/s12204-021-2303-7

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3D-Printed Guide Plate Assisted Osteochondral Transplantation for the Treatment of Large Talar Defect:#br# Case Report and Literature Analysis

YAO Xiangyuna (姚湘云), GAN Yaokaia,b (干耀恺), SHI Dingweia (史定伟), XU Chena,b (徐辰), ZHAO Jiea,b (赵杰), DAI Keronga,b (戴尅戎)   

  1. (a. Department of Orthopaedic Surgery; b. Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People’s
    Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China)
  • 出版日期:2021-06-28 发布日期:2021-06-02
  • 通讯作者: GAN Yaokai (干耀恺) E-mail:ganyk2004@126.com
  • 基金资助:
    the Clinical Research Program of 9th
    People’s Hospital, Shanghai Jiao Tong University
    School of Medicine (No. JYLJ015); the Clinical Research
    Plan of SHDC (No. 16CR3099B); the National
    Key Research and Development Program of China
    (No. 2017YFC1103900); the Class IV Peak Subject
    Program of Shanghai Jiao Tong University School of
    Medicine (No. GXQ03)

3D-Printed Guide Plate Assisted Osteochondral Transplantation for the Treatment of Large Talar Defect:#br# Case Report and Literature Analysis

YAO Xiangyuna (姚湘云), GAN Yaokaia,b (干耀恺), SHI Dingweia (史定伟), XU Chena,b (徐辰), ZHAO Jiea,b (赵杰), DAI Keronga,b (戴尅戎)   

  1. (a. Department of Orthopaedic Surgery; b. Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People’s
    Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China)
  • Online:2021-06-28 Published:2021-06-02
  • Contact: GAN Yaokai (干耀恺) E-mail:ganyk2004@126.com
  • Supported by:
    the Clinical Research Program of 9th
    People’s Hospital, Shanghai Jiao Tong University
    School of Medicine (No. JYLJ015); the Clinical Research
    Plan of SHDC (No. 16CR3099B); the National
    Key Research and Development Program of China
    (No. 2017YFC1103900); the Class IV Peak Subject
    Program of Shanghai Jiao Tong University School of
    Medicine (No. GXQ03)

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摘要： Osteochondral lesion of the talus (OLT) is a common cause of ankle pain that often occurs in the  talar dome and leads to talar cartilage and subchondral bone damage. Osteochondral autograft transplantation  is a logical treatment option. It is known that if the cartilage does not heal properly after injury, it degenerates,  and osteoarthritis worsens. A three dimensional (3D)-printed guide plate can be used to find the curved articular  surface from the donor site which optimally fits the defect in the talus. Herein, we present the case of a 28-year-old  man who had an open injury from the crash of a tricycle in the right ankle at the age of 5. Radiographs revealed  a large defect in the medial talar dome that affected nearly half of the talar dome. We performed the debridement  of the ankle lesion. An osteochondral autograft was harvested from the medial femoral condyle (MFC) with the  help of a personalised 3D-printed guide plate. This 3D-printed guide plate simulated the contour of a specific  area in the talar dome, which involved the site of the defect. The autograft was then transplanted into the talus  defect. The efficacy of this technique was evaluated at 2, 4, and 7 months after surgery and proven to be reliable.

Abstract: Osteochondral lesion of the talus (OLT) is a common cause of ankle pain that often occurs in the  talar dome and leads to talar cartilage and subchondral bone damage. Osteochondral autograft transplantation  is a logical treatment option. It is known that if the cartilage does not heal properly after injury, it degenerates,  and osteoarthritis worsens. A three dimensional (3D)-printed guide plate can be used to find the curved articular  surface from the donor site which optimally fits the defect in the talus. Herein, we present the case of a 28-year-old  man who had an open injury from the crash of a tricycle in the right ankle at the age of 5. Radiographs revealed  a large defect in the medial talar dome that affected nearly half of the talar dome. We performed the debridement  of the ankle lesion. An osteochondral autograft was harvested from the medial femoral condyle (MFC) with the  help of a personalised 3D-printed guide plate. This 3D-printed guide plate simulated the contour of a specific  area in the talar dome, which involved the site of the defect. The autograft was then transplanted into the talus  defect. The efficacy of this technique was evaluated at 2, 4, and 7 months after surgery and proven to be reliable.
 

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