Mid-term outcomes following acute particulated autologous cartilage implantation to treat displaced traumatic osteochondral lesions of the talus

The purpose of this study was to report on a small case series of patients undergoing particulated autologous cartilage implantation (PACI) for to treat traumatic displaced OLTs. Four patients underwent PACI procedures at a median time of 16.5 days (range 6 to 26) after the initial trauma. Demographic data, mechanism of injury, OLT characteristics, concomitant procedures, complications, and reoperations were recorded. Postoperative patient-reported outcome measures were collected including the Visual Analog Score (VAS), Short-Form -12 (SF-12), foot and ankle ability measure (FAAM), and American Orthopaedic Foot and Ankle Surgery (AOFAS) hindfoot scores. Postoperative MRI and second-look arthroscopy were assessed for two patients. The mean age of the cohort at the time of the PACI procedure was 23.3 (range 15 to 37) years. At a mean most recent follow-up of 61.8 months (range 33 to 99), the mean postoperative patient-reported outcomes scores were: VAS (0.5; range 0 to 1), PCS SF-12 (45.2; range 34.99 to 54.44), MCS SF-12 (44.1; range 37.75 to 49.2), FAAM ADL (87.5; range 70 to 100), FAAM sporting (71.5; range 29 to 100), and AOFAS hindfoot (86.3; range 77 to 100). The mean time to return to preinjury activity was 7.0 4 to 9 months. There were no graft-related complications. Two of the patients underwent second-look arthroscopy and were found to have intact repairs. The PACI showed promising midterm clinical outcomes and return to preinjury activity level without graft-related complications for irreducible displaced traumatic OLTs. Although our study showed promising outcomes at 61.8 months follow-up, larger cohort studies with standardized surgical protocols are needed to determine whether PACI has favorable outcomes comparted to other restorative and reparative OLT procedures.