Colin Mizuo, Liliya Parkman, Tarina Ayazi, Haoning Hu, Ashley Adams
In this high-demand cohort, PJCA implantation was associated with radiographic evidence of defect fill, pain relief, functional restoration, and return to activity without donor-site morbidity. Despite the study's retrospective design and moderate follow-up, these findings support PJCA as a promising option for talar OCD repair. Prospective, randomized trials with extended follow-up are warranted to confirm durability and efficacy against established techniques.
BACKGROUND: Osteochondral defects (OCDs) of the talus frequently affect young, active individuals and carry a risk of chronic pain and joint degeneration. Particulated juvenile cartilage allograft (PJCA), harnesses the proliferative capacity of juvenile chondrocytes to restore hyaline cartilage without donor-site morbidity. This study evaluates the structural, clinical, and functional outcomes of PJCA implantation in active-duty military patients.
METHODS: We retrospectively reviewed 10 service members (10 male, mean age 28.4 years) who underwent arthroscopic PJCA implantation for symptomatic talar OCDs. Outcomes included defect dimensions and volume on magnetic resonance imaging (MRI), Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scores, visual analog scale (VAS) for pain, and Foot and Ankle Ability Measure (FAAM) subscales. Statistical analyses employed Wilcoxon signed-rank and Friedman tests (SPSS 28.0), with significance set at P <.05.
RESULTS: Median follow-up was 15.0 months (range 13.5-18.2). Lesion volume decreased from 0.77 to 0.02 cm³ (P = .027). Median MOCART scores improved from 25 to 75 (P = .027). Pain scores fell from 6.0 to 1.0 (P < .001). FAAM daily living scores increased from 50% to 87.5% (P < .001), and sports scores from 15% to 85% (P < .001). Nine of 10 patients returned to full duty (8/9 after a single limited-duty period, 1 required 2 limited-duty periods), and 1 required medical separation. No complications were observed.
CONCLUSION: In this high-demand cohort, PJCA implantation was associated with radiographic evidence of defect fill, pain relief, functional restoration, and return to activity without donor-site morbidity. Despite the study's retrospective design and moderate follow-up, these findings support PJCA as a promising option for talar OCD repair. Prospective, randomized trials with extended follow-up are warranted to confirm durability and efficacy against established techniques.
LEVEL OF EVIDENCE: Level IV, retrospective case series.