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Osteochondral defects of the talus with a focus on platelet-rich plasma as a potential treatment option: a review
  1. Ahmed Aly Elghawy,
  2. Carlos Sesin,
  3. Michael Rosselli
  1. Internal Medicine, Mount Sinai Medical Center, Miami Beach, Florida, USA
  1. Correspondence to Dr Ahmed Aly Elghawy; ahelghawy{at}gmail.com

Abstract

Objective To provide a review of osteochondral lesions of the talus, to discuss the evidence of the risks and benefits of platelet-rich plasma (PRP) as a viable treatment option, and to measure the efficacy of PRP using MRI evidence of cartilage regeneration, as well as scales that measure improvement in ‘pain’ and ‘functionality’.

Eligibility criteria Studies that use PRP in either conservative or intraoperative settings to treat osteochondral defects of the talus.

Results There are seven studies that compare hyaluronic acid or standard surgical options against PRP in treating osteochondral lesions of the talus. Five studies use PRP as supplemental treatment in intraoperative settings, while two studies use PRP conservatively as intra-articular injections. There were minimal adverse effects. Pain and functionality scores consistently improved in those who underwent PRP treatments over the course of 4 years. MRI showed significant but inconsistent results in chondral regeneration.

Conclusion PRP may show clinical benefit in those with osteochondral lesions of the talus in terms of pain and functionality, although chondral regeneration via MRI is inconsistent. Limitations include the small sample sizes in these seven studies, as well as no standardised formula for PRP preparation.

Clinical relevance To serve as an overview of the literature regarding PRP treatment for osteochondral lesions of the talus and how this modality may improve patient outcomes in pain, functionality and chondral regeneration. A case is reported to complement the subject review.

  • platelet-rich plasma
  • ankle
  • cartilage

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors AAE contributed the idea of the manuscript, initial registration of review, initial search, review of data, initial drafting and editing of manuscript. CS and MR contributed to editing of the manuscript. All authors approved the final draft of the manuscript.

  • Funding None declared.

  • Competing interests None declared.

  • Ethics approval All previous studies included in this review have been approved by the ethics committees before their publication.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data available on request.

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