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| |  New Technique To Repair Common Sports Injury Fields Excellent Results PORTSMOUTH, NH -- November 18, 1997 -- A painful and sometimes debilitating injury to the talus (the saddle-shaped bone at the base of the ankle) can be repaired by transplanting bone and cartilage from the knee to the talus. A study in the October issue of Foot and Ankle International reports a technique called mosiacplasty achieved excellent results in repairing a common sports injury, osteochondritis dissecans (OCD), that generally strikes active children, young adults and athletes. OCD is a deep bruise of the joint involving the cartilage surface and underlying bone. In cases where the bruise does not heal, the dead cartilage and bone will loosen and the patient will experience pain as a result of these loose pieces of bone catching in the joint and also from walking and running on a raw bony surface without the shock absorbing cushion of cartilage. OCD often results from an injury to the ankle (such as a sprain) and is commonly seen in basketball, soccer and volleyball players. The researchers used mosiacplasty, a procedure that has been used successfully in the repair of knee joints, to repair talus bones damaged by OCD. Mosiacplasty involves removing small cartilage and bone plugs from non-weightbearing parts of the knee, then filling in the painful defects in the talus caused by OCD. "Some liken mosiacplasty to hair plug transplants," explains Gary Kish, M.D., Portsmouth, N.H., team physician for the University of New Hampshire football program and an author of this study. "Each technique involves the use of a unit, a hair and scalp plug or a bone and cartilage plug, which can survive the transfer and retain its integrity. A successful hair plug transplant will retain color, texture and ability to grow. "In the case of cartilage-bone plugs, incorporation into the talus and ability to withstand the forces of weight bearing are hallmarks of a successful transplant." This preliminary report followed 11 patients whose OCD was treated with mosiacplasty for 12 to 28 months. Excellent results were reported in all 11 ankles and nine of 11 patients reported no problems with the donor knee. The remaining two patients indicated that the donor knee caused them only occasional pain, no work limitations and moderately decreased sporting activity. "Our patients recover full knee function after six weeks and no long-term knee joint morbidity has been shown to date," Dr. Kish explained. "The advantage of this procedure is that it uses only very small diameter grafts from the non-weightbearing areas of the knee. "The use of the person's own tissue rather than artificial matrices or cadaver bone/cartilage increases the chances of success with this procedure and diminishes the risk of infection and rejection."
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