{
  "abstract": "Background\n\nEvidence regarding arthroscopic autologous iliac crest cancellous bone grafting for Hepple stage V osteochondral lesions of the talus (OLTs) remains limited. This study assessed short-term clinical outcomes, postoperative imaging findings, and perioperative characteristics of this technique.Methods\n\nThis retrospective case series included 23 patients undergoing arthroscopic autologous iliac crest cancellous bone grafting between March 2020 and July 2024. Preoperative magnetic resonance imaging (MRI) and computed tomography (CT) demonstrated subchondral cystic changes in all lesions, which were classified as Hepple stage V OLTs. The primary outcome was the European Foot and Ankle Society (EFAS) score at final follow-up. Secondary outcomes included the Visual Analogue Scale (VAS) pain score during walking, the American Orthopaedic Foot & Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), 36-Item Short Form Health Survey (SF-36) pain domain score, Tegner score and ankle range of motion (ROM). Postoperative radiographs and available CT scans were reviewed to assess graft position and subchondral healing; MRI findings were also evaluated when available. Operative time, concomitant lateral ligament repair, and complications were documented. Paired comparisons were performed using the paired t-test or Wilcoxon signed-rank test, as appropriate after assessment of normality.Results\n\nMean follow-up was 21.0 ± 8.7 months (median, 18.0 months; Q1-Q3, 13.0-24.0), and mean lesion area was 1.94 ± 0.38 cm². Median operative time was 75.0 min (Q1-Q3, 67.5-86.0), and five patients underwent concomitant lateral ligament repair. The median EFAS score improved from 9.0 (Q1-Q3, 8.0-10.0) preoperatively to 19.0 (Q1-Q3, 18.0-20.0) at final follow-up (P < 0.001). All other clinical outcome measures also improved significantly (all P < 0.001). Radiographs obtained in all 23 patients demonstrated maintained graft position. Among the 17 patients who underwent postoperative CT, structural graft incorporation was observed in all cases. MRI was obtained in eight selected patients and demonstrated no graft displacement. No major complications were observed. One patient experienced transient mild donor-site pain that resolved with conservative treatment, whereas another had delayed recovery with mild residual ankle pain.Conclusions\n\nArthroscopic autologous iliac crest cancellous bone grafting was associated with improvements in pain, function, and activity in patients with Hepple stage V OLTs at short-term follow-up. Postoperative CT demonstrated graft incorporation in all patients who underwent CT assessment. These preliminary findings support the feasibility of this technique for appropriately selected cystic lesions, although larger comparative studies with longer follow-up are warranted.",
  "abstract_shown": true,
  "affiliations": [
    "Sports Medicine Department, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, No. 199, the Jiefang South Road, Xuzhou, 221009, Jiangsu, People's Republic of China.",
    "Orthopaedic Department, The Second Hospital of Tangshan, Tangshan, 063000, Hebei, People's Republic of China.",
    "Department of Sports Traumatology, Università Telematica San Raffaele, Via di Val Cannuta, 247, Rome, Italy.",
    "Department of Orthopaedic Surgery, Sant'Andrea Hospital, University La Sapienza, Rome, Italy.",
    "Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, ST4 7QB, England.",
    "Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England.",
    "Department of Trauma and Reconstructive Surgery, University Hospital Halle, Martin-Luther University Halle-Wittenberg, Ernst-Grube-Street 40, 06097, Halle (Saale), Germany. filippo.migliorini@uk-halle.de.",
    "Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165, Rome, Italy. filippo.migliorini@uk-halle.de.",
    "Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152, Simmerath, Germany. filippo.migliorini@uk-halle.de.",
    "Sports Medicine Department, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, No. 199, the Jiefang South Road, Xuzhou, 221009, Jiangsu, People's Republic of China. fengshiming_04@163.com."
  ],
  "article_type": "research article",
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  "author_total": 8,
  "authors": [
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        0
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      "name": "Zi-He Zhang"
    },
    {
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        0
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      "name": "Chong Xue"
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    {
      "affs": [
        0
      ],
      "name": "Chao-Fan Su"
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    {
      "affs": [
        1
      ],
      "name": "Shun-Hong Gao"
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    {
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        2
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      "name": "Francesco Oliva"
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    {
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        4,
        5
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      "name": "Nicola Maffulli"
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    {
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        6,
        7,
        8
      ],
      "name": "Filippo Migliorini",
      "orcid": "0000-0001-7220-1221"
    },
    {
      "affs": [
        9
      ],
      "name": "Shi-Ming Feng",
      "orcid": "0000-0002-0815-2426"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/aex3z2yfzb9pf.bib",
  "cited_by": 0,
  "doi": "10.1186/s13018-026-07356-4",
  "fulltext_url": "https://europepmc.org/articles/PMC13726053",
  "id": "aex3z2yfzb9pf",
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  "landing_url": "https://europepmc.org/article/MED/42968155",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
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  "pdf_url": "https://europepmc.org/articles/PMC13726053?pdf=render",
  "pmcid": "PMC13726053",
  "pmid": "42968155",
  "published": "2026-11-02",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/aex3z2yfzb9pf.ris",
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  "subjects": [
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      "origin": "openalex:2732|Foot and Ankle Surgery",
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  "title": "Arthroscopic autologous iliac crest cancellous bone grafting for Hepple stage V osteochondral lesions of the talus: a retrospective case series.",
  "title_text": "Arthroscopic autologous iliac crest cancellous bone grafting for Hepple stage V osteochondral lesions of the talus: a retrospective case series.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:06Z",
  "url": "https://research.draconitic.com/paper/aex3z2yfzb9pf",
  "venue": "Journal of orthopaedic surgery and research",
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}