Gait Pattern Analysis After Arthroscopic Treament of Osteochondral Defects of Talus

NCT07161128 | Enrolling By Invitation

• 1 other identifier: Gazi University Hospital
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The study will investigate alterations in post-surgical gait patterns among patients who have undergone all arthroscopic microfracture and biological scaffold implementation surgery for the osteochondral lesions of talus. The gait biomechanics of patients scheduled for surgery will be assessed preoperatively using pedobarographic analysis. Subsequent changes in walking biomechanics will be evaluated and interpreted at the 6th postoperative months. Consequently, the impact of the all arthroscopic treatment of osteochondral lesions of talus on walking will be documented.

Conditions

Osteochondral Defects of Talus; Gait Analysis; Microfracture Procedure; Biological Scaffold

Keywords

pedobarography; gait analysis; ocd of talus; microfracture

Outcome Measures

Primary Outcomes (4)

• Peak Plantar Pressure (kPa) in Pedobarographic analysis

  Peak plantar pressure will be assessed using a computerized pedobarographic platform equipped with pressure sensors and dedicated gait analysis software. Patients will walk barefoot at a self-selected, comfortable speed with arms relaxed at the sides, following a natural gait. In each session, five valid gait trials will be recorded. For each trial, the maximum plantar pressure value under the entire foot during stance will be extracted. The mean value of the five trials will be reported. This outcome quantifies the highest load experienced by the plantar surface during walking and will allow comparison of preoperative and postoperative gait biomechanics.

  Baseline (1 day before surgery) and 6 months after surgery

• Plantar Pressure-Time Integral (kPa·s) in Pedobarograpic Analysis

  The plantar pressure-time integral will be measured using the same pedobarographic platform. During dynamic gait analysis, patients will complete five valid walking trials at a natural speed. For each trial, the cumulative pressure applied over time to the plantar surface during the stance phase will be calculated and expressed as kPa·s. The average of the five trials will be reported. This measure reflects the duration and magnitude of plantar loading and provides information on changes in gait mechanics following surgery.

  Baseline (1 day before surgery) and 6 months after surgery

• Plantar Contact Area (cm²) in Pedobarographic Analysis

  Plantar contact area will be evaluated using the pedobarographic platform during dynamic gait analysis. Patients will walk at a self-selected speed, and five valid gait trials will be collected. For each trial, the total plantar surface area in contact with the platform during stance will be computed and expressed in square centimeters. The mean of the five trials will be reported. This outcome reflects how much of the plantar surface participates in load transfer during walking and will be used to assess functional improvement after surgery.

  Baseline (1 day before surgery) and 6 months after surgery

• Center of Pressure Excursion Index (%) in Pedobarographic Analysis

  The Center of Pressure (COP) Excursion Index will be calculated from dynamic pedobarographic recordings. Patients will walk barefoot at a self-selected, comfortable speed, with five valid gait trials collected per session. The COP trajectory during stance will be analyzed, and the mediolateral deviation of the COP path will be expressed as a percentage relative to foot width (Excursion Index). The average value from the five trials will be reported. This outcome reflects dynamic postural control and foot loading patterns during gait and will be compared between the preoperative and postoperative assessments.Baseline (1 day before surgery) and 6 months after surgery

  Baseline (1 day before surgery) and 6 months after surgery

Secondary Outcomes (1)

• American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS)

  Baseline (1 day before surgery) and 6 months after surgery

Study Arms (1)

Microfracture + Biologic Scaffold

EXPERIMENTAL

Procedure: arthroscopic microfracture and biological scaffold implementation for osteochondral defects of talus

Interventions

arthroscopic microfracture and biological scaffold implementation for osteochondral defects of talus PROCEDURE

All enrolled patients will undergo a standardized single-stage arthroscopic procedure under spinal or general anesthesia with the patient supine and the ankle placed in appropriated position. Standard anteromedial and anterolateral portals are established. The talar osteochondral defect is inspected, measured, and any unstable cartilage is sharply débrided to create stable vertical walls, exposing healthy subchondral bone. Using a 1.0- to 1.2-mm awl, multiple perforations are made perpendicular to the lesion base, 3-4 mm apart and \~2-4 mm deep, until uniform "marrow fat-bleeding" is observed-mobilizing mesenchymal stem cells .A sterile, resorbable, type-I/III collagen bilayer scaffold is trimmed to the exact defect footprint using a template fashioned intra-operatively.

Microfracture + Biologic Scaffold

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• presence of osteochondral defect on talus confirmed with MRI
• planning for arthroscopic microfracture+ biological scaffold surgery

You may not qualify if:

• presence of foot and ankle deformities
• Presence of orthopedic or neurological pathologies that may affect walking biomechanics.
• History of prior foot and ankle surgery.

Sponsors & Collaborators

• Gazi University: lead

Study Sites (1)

Gazi University Hospital

Ankara, Ankara, 06560, Turkey (Türkiye)

Location

Related Publications (8)

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  PMID: 11681548 BACKGROUND

• Giannini S, Buda R, Cavallo M, Ruffilli A, Cenacchi A, Cavallo C, Vannini F. Cartilage repair evolution in post-traumatic osteochondral lesions of the talus: from open field autologous chondrocyte to bone-marrow-derived cells transplantation. Injury. 2010 Nov;41(11):1196-203. doi: 10.1016/j.injury.2010.09.028. Epub 2010 Oct 8.

  PMID: 20934692 BACKGROUND

• Ramponi L, Yasui Y, Murawski CD, Ferkel RD, DiGiovanni CW, Kerkhoffs GMMJ, Calder JDF, Takao M, Vannini F, Choi WJ, Lee JW, Stone J, Kennedy JG. Lesion Size Is a Predictor of Clinical Outcomes After Bone Marrow Stimulation for Osteochondral Lesions of the Talus: A Systematic Review. Am J Sports Med. 2017 Jun;45(7):1698-1705. doi: 10.1177/0363546516668292. Epub 2016 Nov 16.

  PMID: 27852595 BACKGROUND

• Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy. 2003 May-Jun;19(5):477-84. doi: 10.1053/jars.2003.50112.

  PMID: 12724676 BACKGROUND

• Migliorini F, Eschweiler J, Maffulli N, Schenker H, Driessen A, Rath B, Tingart M. Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study. Life (Basel). 2021 Mar 16;11(3):244. doi: 10.3390/life11030244.

  PMID: 33809441 BACKGROUND

• Cheng L, Wang X. Advancements in the treatment of osteochondral lesions of the talus. J Orthop Surg Res. 2024 Dec 6;19(1):827. doi: 10.1186/s13018-024-05314-6.

  PMID: 39639331 BACKGROUND

• Gianakos AL, Yasui Y, Hannon CP, Kennedy JG. Current management of talar osteochondral lesions. World J Orthop. 2017 Jan 18;8(1):12-20. doi: 10.5312/wjo.v8.i1.12. eCollection 2017 Jan 18.

  PMID: 28144574 BACKGROUND

• Ferkel RD, Zanotti RM, Komenda GA, Sgaglione NA, Cheng MS, Applegate GR, Dopirak RM. Arthroscopic treatment of chronic osteochondral lesions of the talus: long-term results. Am J Sports Med. 2008 Sep;36(9):1750-62. doi: 10.1177/0363546508316773.

  PMID: 18753679 BACKGROUND

MeSH Terms

Conditions

Fractures, Stress

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief Resident in Orthopaedic Surgery, Principal Investigator

Study Record Dates

• First Submitted: June 16, 2025
• First Posted: September 8, 2025
• Study Start: June 1, 2024
• Primary Completion: December 31, 2025
• Study Completion: March 1, 2026
• Last Updated: September 8, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

TU (1)