Several technique pearls are provided related to performing the osteotomy and to ensure the allograft implant is well contoured to fit. This code will cover the right ankle arthroscopy, oats procedure, medial talus, with harvest from right knee. Osteochondral allograft of the talus pubmed central pmc. Our reoperation rate is comparable with other oca studies 25,34,36 and is expected in a young and active population at high risk for further injuries in the knee. The prophecy guides allows for improved accuracy of the surgery and faster recovery. You should do at least 10 ankle pump exercises each hour. Osteochondral allograft transplantation for knee lesions. A metaanalysis of autologous chondrocyte implantation in the ankle found there was a lack of level i studies to conclude that autologous chondrocyte implantation was superior or inferior to comparable techniques despite initial success rates close to 90 percent. The next step for me would be an mri and then possibly another microfracture or oats or an ankle fusion.
Why microfracture knee surgery success rate fails over time. Athletes can expect to return to their sport in 99 months. What is the osteoarticular transfer system procedure. Gill approximately ten to fourteen days after your surgery. Last august i had left ankle orthroscopic surgery to try to correct an ocd lesion. Ankle replacement surgery gets an upgrade advanced foot and. I dont understand why he didnt do it from the start then.
Success rates of osteochondral allograft of the talus are reported to range between 73% and 100%. Rehabilitation and return to play following osteochondral. Repair of adult human cartilage a significant challenge. Nov 02, 2015 os explained that the oats procedure has a significantly higher success rate than microfracture. There is an estimated 7585% success rate for this type of procedures. A higher success rate and restoration of cartilage biomechanically equal to the originals make oats procedure a popular option. Arthrex fresh allograft oats technique for osteochondral. Osteochondral autologous autograft oats procedure indications. Oats knee surgery procedure at detroit medical center youtube.
New procedure bests standard of care for fixing damaged. A simplified pooling method resulted in a calculated mean success rate of 90 % ci. May 23, 2019 total ankle replacement a levelii prospective cohort study compared outcomes of oldergeneration and newergeneration total ankle replacements n 170 with ankle arthrodesis n 103. New procedure bests standard of care for fixing damaged cartilage. Oats procedure what is the typical recovery time from an oats. From what i understand they basically take a plug of bone and cartilage from my knee and put it in my ankle. While earlier generation ankle replacement systems were effective, newer advances have dramatically improved the procedure. The procedure is indicated for patients with meniscal tears or loose bodies and may postpone the need for total knee arthroplasty. A mosaicplasty uses cartilage from undamaged areas of the joint and moves this cartilage to a damaged. One study, completed in 2016 reported that 72 % of patients showed overall success after an oats surgery. We and others have demonstrated that the oat procedure has an approximately 90% success rate in returning patients to competitive sports. The authors noted an overall rtp rate of 73%, with microfracture having the lowest rtp rate at 66%, followed by 67% for aci, and 91% for oats. Oats procedure is a surgical technique to replace torn knee cartilages with a healthy one. Rehabilitation guidelines following osteochondral allograft.
Gary gilyard helps a dedicated hockey player with a devastating knee injury get back on the ice. In normal walking each year you take 23 million steps at up to 5 times your body weight depending on the height of the step. Some previous activities are limited due to the pain. Oats is one technique of several used to treat this problem.
If there is a large bony and cartilage defect, these can be replaced with cartilage and bone from the knee, known as an osteochondral autograft technique oat. Success rates of osteochondral allograft of the talus are reported to range between 73% and 100 %. I am scheduled to have this procedure done on 82112. During the oats procedure, bottom left, the osteochondral grafts are harvested from the knee and immediately used to repair the talar lesion. I had ankle debridement and microfracture 2 years ago and still have significant pain in the ankle. Recovery is nonweight bearing for 48 weeks, which will be amazing with a twostory house and three kids 10, 4, 5 months. Oats is typically used for patients aged success rates of osteochondral allograft of the talus are reported to range between 73% and 100%. Oats surgery forney cartilage transfer procedures terrell. Oats procedure for an ocd lesion of the capitellum.
Failures can be treated with a revision allograft transplantation bipolar or not, ankle fusion or total ankle arthroplasty. Oats oatsmosaicplasty joint replacement patient forum. Sounded just horrific so i am hoping for a really high. Does anyone know what the success rate is for microfracture surgery for ocd of talus. When microfracture fails, it is because natural healing alone is simply not effective often enough on a surface that sees so much force, never mind the torque and stress of pivoting sports. In the oats procedure, the surgery usually begins with an arthroscopic examination. Osteochondral allograft transplantation in the ankle. Osteochondral autografting for all other joints, including but not limited to. Repair of adult human cartilage a significant challenge for. Questions to ask your doctor before surgery orthoinfo aaos.
Understanding the osteoarticular transfer system oats procedure. But, it still was painful not to have a chair or something to rest your leg on at least level with the chair you are sitting on. Assessing postop outcomes with cartilage repair in athletes. At the 3year followup, both replacement and fusion resulted in improved function and reduced pain, and a pooled comparison of all outcome scores revealed. The oats procedure, an abbreviation for osteoarticular transfer system, is a surgical procedure used to treat focal cartilage defects. A study by gudas et al3 found that 93% of patients who had an oats procedure were able to return to their preinjury level of sports versus 52% who underwent microfracture. San franciscofebruary 8, 2012 a new study has demonstrated that a procedure wherein healthy cartilage is transplanted to fix an area of damaged cartilage osteoarticular cartilage transplantation or oats procedure is superior to the standard of care for repairing cartilage defects. For the oats on the ankle or foot, the only coding option for you is 29999 unlisted procedure, arthroscopy. Whats new in foot and ankle surgery 2019 orthobuzz. The ability to return to sport is also dependent on the size of the lesion or degree of injury, patient age. Recent advancements in ankle replacement surgery has increased the success rates and significantly improved the surgical procedure. Harris, md, pasadena, ca performs an allograft oats technique to treat a talar osteochondral lesion. During the oats procedure, bottom left, the osteochondral grafts are harvested from the knee and immediately used.
There was such limited information on rtp within the one oca study that no signi. Its also possible they will have to cut out a piece of my tibia to access my talus bone. My os recommended today that the next best step is to have the oats procedure done. An osteochondral lesion of the talus olt is an area of abnormal, damaged cartilage and bone on the top of the talus bone the lower bone of the ankle joint. A closer look at drilling and cartilage replacement for. The success rate and longevity in other joints have not been proven at this time.
Varied success rates seen with articular cartilage knee. A study of 96 patients compared the oats procedure to microfracture treatment for isolated articular cartilage defects of the knee. Because of this, it does not take on the mosaic appearance, but the principle is the same. The patients were on average 3032 years old and were followed yearly for five years after surgery. It took me 5 years of constant nagging for the doctor to even take any notice of me, telling me i was doing too much sport. Finally he referred me to a knee and ankle specialist who tried other operations first and said because of my age it will heal itself. In the oats procedure, the plugs are usually larger, and therefore only one or two plugs are needed to fill the area of cartilage damage. Procedureproduct pages 1 oats technique the disposable donor and recipient cutting tube sets of the singleuse osteochondral autograft transplant system oats kit facilitate harvesting of various diameter osteochondralhyaline cartilage cylinders from a donor site superior and lateral to the femoral notch or above the sulcus terminalus.
Oats stands for osteochondral autograft transfer system, and the technique is very similar to mosaicplasty. Recently the pain has returned and at times i find it almost impossible to support my own body weight. An oatstype procedure is reserved for patients who have been treated with arthroscopic cleaning out debridement and microfracture and are still not doing well or patients that have a very large 20mm. Several technique pearls are provided related to performing the osteotomy and to ensure the allograft implant is well contoured to fit the surrounding cartilage following implantation. Oats undergoing a concomitant procedure in 60% of cases. A closer look at drilling and cartilage replacement for talar. Oct 14, 2012 you report this with code 28446 open osteochondral autograft, talus includes obtaining grafts. Had an mri done today and found out the surgery was not successful. San franciscofebruary 8, 2012 a new study has demonstrated that a procedure wherein healthy cartilage is transplanted to fix an area of damaged cartilage osteoarticular cartilage transplantation or oats procedure is superior to the standard of care for. Mar 01, 2017 the biouni oats surgical technique is the new standard for restoration of the articular surface when presented with elongated cartilage defects in the femoral condyle. Oats knee surgery can provide pain relief, increased mobility, strength and stability for those who have suffered from injury for years. Reported success rates are highly variable and depend largely on each authors definition of success.