Mid-Term Outcomes of Complex Talus Osteochondral Defect Treatment with Episealer Implantation

Research Type: Level 4 – Case series Introduction/Purpose: Background and Purpose: Focal cartilage lesions often cause significant functional impairment. Biological treatments have yielded suboptimal results in middle-aged patients, and previous studies on focal prosthetic inlay resurfacing have reported a higher risk of conversion to ankle fusion. A novel, customized implant (Episealer, Episurf, Stockholm, Sweden) has been developed to improve implant positioning and longevity. The primary objective was to assess subjective, objective function and implant survival at a one year after surgery. Methods: Materials and Methods: This is a multicenter study that analyzed consecutive patients undergoing Episealer implantation for symptomatic focal talar chondral defects, including lesions that have failed conservative or prior surgical management. Patient-reported outcome measures at one-year follow-up were compared with baseline data using the Foot and Ankle Outcome Score (FAOS) and the Numeric Rating Scale (NRS) for pain. Complication and revision rates were also assessed. Results: Results: Fifteen patients with one-year follow-up were included. Both NRS pain scores and FAOS demonstrated significant improvement (p ≤ 0.001). No revisions to ankle replacement were required. Conclusion: This customized focal ankle-resurfacing implant demonstrated favorable subjective outcomes, and low complication and revision rates at one-year follow-up.