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Effect of graft height mismatch on contact pressures with osteochondral grafting of the talus.

Publication ,  Journal Article
Latt, LD; Glisson, RR; Montijo, HE; Usuelli, FG; Easley, ME
Published in: Am J Sports Med
December 2011

BACKGROUND: Osteochondral allograft transplantation is technically demanding. It is not always possible to place the surface of the graft perfectly flush with the surrounding cartilage. One must often choose between placing at least some portion of the surface of the graft slightly elevated or recessed. The effect of this choice on joint contact pressure is unknown. PURPOSE: This study was undertaken to determine the effect of graft height mismatch on joint contact pressure in the ankle. STUDY DESIGN: Controlled laboratory study. METHODS: Ten human cadaveric ankles underwent osteochondral grafting by removal then replacement of an osteochondral plug. Six conditions were tested: intact, graft flush, graft elevated 1.0 mm, graft elevated 0.5 mm, graft recessed 0.5 mm, and graft recessed 1.0 mm. Joint contact pressures were measured with a Tekscan sensor while loads of 200 N, 400 N, 600 N, and 800 N were sequentially applied. RESULTS: The peak contact pressure at the graft site for the flush condition was not significantly different from the intact condition for either medial or lateral lesions. In contrast, peak pressure on the opposite facet of the talar dome was significantly increased during the flush condition for the medial but not the lateral grafts. Elevated grafts experienced significantly increased contact pressures, whereas recessed grafts experienced significantly decreased pressures. These changes were greater for lateral than for medial lesions. Reciprocal changes in joint contact pressures were found on the opposite facet of the talus with elevated grafts on the lateral side and recessed grafts on the medial side. CONCLUSION: Flush graft placement can restore near-normal joint contact pressure. Elevated graft placement leads to significant increases in joint contact pressure at the graft site. Recessed graft placement leads to a transfer of pressure from the graft site to the opposite facet of the talus. CLINICAL RELEVANCE: Osteochondral grafts in the talus should be placed flush if possible or else slightly recessed.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

December 2011

Volume

39

Issue

12

Start / End Page

2662 / 2669

Location

United States

Related Subject Headings

  • Talus
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cartilage
  • Bone Transplantation
  • Arthroplasty, Subchondral
  • Ankle Joint
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Latt, L. D., Glisson, R. R., Montijo, H. E., Usuelli, F. G., & Easley, M. E. (2011). Effect of graft height mismatch on contact pressures with osteochondral grafting of the talus. Am J Sports Med, 39(12), 2662–2669. https://doi.org/10.1177/0363546511422987
Latt, L Daniel, Richard R. Glisson, Harvey E. Montijo, Federico G. Usuelli, and Mark E. Easley. “Effect of graft height mismatch on contact pressures with osteochondral grafting of the talus.Am J Sports Med 39, no. 12 (December 2011): 2662–69. https://doi.org/10.1177/0363546511422987.
Latt LD, Glisson RR, Montijo HE, Usuelli FG, Easley ME. Effect of graft height mismatch on contact pressures with osteochondral grafting of the talus. Am J Sports Med. 2011 Dec;39(12):2662–9.
Latt, L. Daniel, et al. “Effect of graft height mismatch on contact pressures with osteochondral grafting of the talus.Am J Sports Med, vol. 39, no. 12, Dec. 2011, pp. 2662–69. Pubmed, doi:10.1177/0363546511422987.
Latt LD, Glisson RR, Montijo HE, Usuelli FG, Easley ME. Effect of graft height mismatch on contact pressures with osteochondral grafting of the talus. Am J Sports Med. 2011 Dec;39(12):2662–2669.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

December 2011

Volume

39

Issue

12

Start / End Page

2662 / 2669

Location

United States

Related Subject Headings

  • Talus
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cartilage
  • Bone Transplantation
  • Arthroplasty, Subchondral
  • Ankle Joint