# Osteochondral Autograft Transplantation Coupled With Platelet-Rich Plasma and Hyaluronic Acid Injections Can Yield Favorable Outcomes in Patients With Osteochondral Lesions of the Talus

## TL;DR

Combining bone graft surgery with PRP and hyaluronic acid injections improves outcomes for patients with ankle bone-cartilage injuries.

## Contribution

Demonstrates favorable clinical outcomes when combining OATS with PRP and HA injections for talus osteochondral lesions.

## Key findings

- Patients showed a 33.40 mean increase in VAS pain scores at 12 months.
- 94% of patients had good to excellent ankle function based on AOFAS scores.
- No long-term donor-site complications were observed.

## Abstract

To evaluate the outcomes of patients who had osteochondral lesions of the talus treated with osteochondral allograft transplants combined with platelet-rich plasma (PRP) and hyaluronic acid (HA).

We aimed to investigate the outcomes of patients who underwent osteochondral autograft transplantation surgery (OATS) from 2015 to 2022. The inclusion criteria for patients to undergo OATS included a defect size greater than 5 mm and failure of conservative management. The preoperative and postoperative visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded and subsequently analyzed using a paired t test. We also performed cohort-specific analyses that included the minimal clinically important difference, patient acceptable symptom state, and substantial clinical benefit. PRP injections were administered at 8 weeks postoperatively and were given every 2 weeks, for 3 total injections. HA was injected once every 6 months for the following 2 years. The minimum follow-up time was 2 years.

At the 12-month follow-up, all 19 patients reported a mean increase in the VAS score of 33.40 (95% confidence interval, 30.9-35.8). The average age was 31 years, and there were 12 male and 7 female patients. Of the 19 patients, 17 reported no restriction of motion, whereas the other 2 patients reported some restriction of dorsiflexion. Ankle function based on the AOFAS scoring system showed good to excellent results in 18 of 19 cases (94%), with no long-term donor-site morbidity and a mean increase of 37.49 (95% confidence interval, 34.7-40). Hardware removal of lag screws was conducted at 12 months after initial surgery; all cases resulted in union of the malleolar osteotomy. The average follow-up time was 3 years.

Combining OATS with PRP-HA injections can yield promising results for patients with osteochondral lesions of the talus, showing significant improvement in VAS and AOFAS scores postoperatively.

Level IV, therapeutic case series.