Design and Application of Two Novel Assistive Devices in Autologous Osteochondral Transplantation for Talar Osteochondral Lesions: A Technical Note.

Autologous osteochondral transplantation (AOT) is a standard treatment for large-sized osteochondral lesions of the talus (OLT); however, the conventional OATS system used intraoperatively sometimes is suboptimal for meeting surgical demands. To address this, we designed two novel assistive devices: a sizing template to guide osteochondral graft orientation, and an impactor rod to facilitate graft insertion. These devices were evaluated in a retrospective consecutive case series of 34 patients (mean age, 44.5±11.8 years) with OLT who underwent AOT. At mean follow‑up of 69.1 ± 18.8 months, VAS pain score decreased from 7.1 ± 1.4 to 1.4 ± 0.7 (p<0.001), AAS score improved from 1.7 ± 0.6 to 5.6 ± 0.9 (p<0.001), FAAM score also significantly increased, and the final MRI‑based MOCART score was 72.6 ± 2.8. The new devices facilitated surgery, improved accuracy, and yielded good clinical outcomes. LEVEL OF EVIDENCE: IV; Retrospective Case Series.