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Oats Technique For Osteocartilaginal Defects Of The Ankle

Article written by: ANDREI BOGDAN, MD, Orthopedics-traumatology doctor

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For all traumatic or chronic diseases of the musculoskeletal system, the Centrokinetic private clinic in Bucharest is prepared with an integrated Orthopedic Department, which offers all the necessary services to the patient, from diagnosis to complete recovery.
The Department of Orthopedic Surgery of the Centrokinetic Clinic is dedicated to providing excellent patient care and exceptional education for young physicians in the fields of orthopedic surgery and musculoskeletal medicine.
Discover the open MRI imaging center in our clinic. Centrokinetic has a state-of-the-art MRI machine, dedicated to musculoskeletal conditions, in the upper and lower limbs. The MRI machine is open so that people suffering from claustrophobia can do this investigation. The examination duration is, on average, 20 minutes.

Centrokinetic attaches great importance to the entire medical act: investigations necessary for correct diagnosis (ultrasound, MRI), surgery, and postoperative recovery.

Lesions of the articular cartilage appear, especially, at the level of the talar dome. The causes can be traumatic, following sports injuries, being associated with other osteoarticular injuries: sprains, ankle dislocations, injuries of the tibial-peroneal syndesmosis, fractures or osteochondritis, subchondral cysts, aseptic necrosis, lesions that ultimately cause severe chondral injuries. 
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If the articular cartilage defect is located deep in the medial area of the talar dome, involving bone lesions, then the surgical technique is the Autologous Osteochondral transplant.

This technique includes the transplantation of an osteochondral cylinder, taken from an area that is not overused, to the lesion area.

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Autologous Osteochondral Transplantation is a procedure in which one or more osteochondral cylinders are taken from a donor area and implanted in the area of the cartilaginous defect. Technically, several osteochondral cylinders are harvested from an unimportant area of the knee - a variable number and of variable dimensions, to cover the surface of the defect as well as possible - with a special instrument.
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The advantages of the technique consist in the possibility of performing in a single operative time, even if there are lesions of the subchondral bone (osteochondritis, degenerative lesions), they are low cost, slower recovery time compared to the autologous chondrocyte implant. The disadvantages of the method consist mainly in adverse effects related to the donor area and the limitation of the surface that can be covered due to the limitation of the area where cylinders can be harvested.

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Postoperatively

After the intervention, the patient remains hospitalized for 1 day. He will receive pain medication and antibiotics during his hospitalization. The operated limb is immobilized, and the patient is advised not to make ankle movements for two days. Free walking is not allowed immediately, the crutches being necessary, even if the chosen intervention was minimally invasive. 

Patients will wear a compressive bandage on the foot for 5 days. Patients can return to daily activities quickly, up to 3-4 weeks, if they have office work, and 10-12 weeks, if they have fieldwork.

At home

Although recovery after this operation is much faster than a classic intervention, it will still take a few weeks for you to fully recover the operated joint. You should expect pain and discomfort for at least a week postoperatively. You can use a special ice pack, which will reduce the pain and inflammation. You must be careful not to lean on the operated area in the first weeks because the pain and discomfort can worsen. You can take a bath, but without wetting the bandage and incisions. The threads are suppressed at 14 days postoperatively.

At 3 months postoperatively, an MRI is necessary to see how the tendon suture heals. Driving is allowed after 6-8 weeks and hard physical work after 10 weeks.

Physical therapy plays a very important role in the rehabilitation program, and the exercises must be followed by a physical therapist until the end of the recovery period.

It is very important to follow the recovery program strictly and seriously for the surgery to be a success. Our medical team works on average with the patient after this intervention, 12-16 weeks until complete recovery of the operated area.

Following any surgery, medical recovery plays an essential role in the social, professional, and family reintegration of the patient. Because we pursue the optimal outcome for each patient entering the clinic, recovery medicine from Centrokinetic is based on a team of experienced physicians and physical therapists and standardized medical protocols.