Foot & Ankle International - 2017 FAI Supplement - 45S

Results: 42 Jones fractures were identified during the 20102015 NFL seasons. 15 players returned to the field in 9
weeks or less after surgery, with 9 requiring a second Jones
fracture surgery. 27 players returned to the field greater than
9 weeks after surgery, with 4 requiring a repeat surgery.
There was an average decrease in performance by 53.2% in
those players returning in 9 weeks or less after their first
Jones fracture surgery, compared to a 9.4% increase in performance in those players returning after at least 9 weeks
from their first Jones fracture surgery.
Conclusion: The results of this study suggest that a quickened
timeline to recovery after Jones fracture injuries to NFL players can lead to poorer outcomes. There was a statistically significant greater increase in need for second Jones fracture
surgery and greater decrease in performance for players returning to play in less than 9 weeks after Jones fracture surgery.
Although professional players are frequently pressured to
return to play as quickly as possible after these injuries, it may
be more advantageous in terms of post-injury performance and
career longevity to extend the timeline for recovery.
Foot & Ankle International, 38(S1)
DOI: 10.1177/1071100717S00041
©The Author(s) 2017

Primary vs Secondary Osteochondral
Autograft Transplantation in Patients
With Large Sized OLT

marrow stimulation (secondary group). After arthroscopic
inspection and debridement for concomitant soft tissue pathologies, conventional OAT procedures were performed. Clinical
outcomes were assessed using visual analog scale (VAS),
American Orthopaedic Foot & Ankle Society (AOFAS) scores,
Foot and Ankle Outcome Score (FAOS) and re-operation rate.
Factors associated with clinical failure were evaluated using
bivariate analysis and logistic regression analysis. Survival outcomes were compared using Kaplan-Meier analysis.
Results: The mean follow-up time was 6.0 years (range
2.0-10.8) and the mean size of the lesion was 194.9 mm2
(range 151.7-296.3). There was no significant difference in
patients` demographics, and preoperative findings between
primary and secondary groups. Postoperative VAS, AOFAS
score, FAOS, and re-operation rate had no significant difference between primary and secondary groups at the last
follow-up. According to bivariate analysis, significant factor associated with clinical failure was not prior marrow
stimulation but more than 225 mm2 of lesion size in preoperative MRI. Logistic regression analysis revealed that preoperative AOFAS score was significant predictor of clinical
failure after the OAT in this study. The survival probabilities were not significantly different between primary and
secondary groups in Kaplan-Meier plots (P = .947).
Conclusion: Outcomes of secondary OAT were comparable to those of primary OAT in the large sized OLT.
Therefore, we suggested that symptomatic patients with
large sized OLT could be initially treated by either
arthroscopic marrow stimulation or OAT and if failed with
marrow stimulation, secondary OAT could be considered.

Kwang Hwan Park, Yeokgu Hwang, MD, Yoo
Jung Park, MD, Dong-Woo Shim, MD, Jin Woo
Lee, MD, PhD
Category: Ankle, Arthroscopy, Sports
Keywords: ankle; osteochondral lesion; marrow stimulation; osteochondral autograft transplantation
Introduction/Purpose: Osteochondral autograft transplantation (OAT) for large sized osteochondral lesions of the talus
(OLT) has presented promising clinical results in recent studies. However, there was no study which has compared clinical
outcomes between primary OAT and secondary OAT in the
large sized OLT. The purpose of this study is to compare clinical outcomes between patients receiving primary transplantation and patients receiving secondary transplantation after
failure of previous marrow stimulation for large sized OLT
and investigate prognostic factor affecting clinical failures.
Methods: Between 2005 and 2014, 18 patients with large sized
OLT (=150 mm2) underwent primary OAT as a primary surgery (primary group) and 28 patients with large sized OLT
underwent secondary OAT after a failure of arthroscopic
AOFAS Annual Meeting 2017

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