JBJS - 2026-04-15 - Journal Article; Case Reports
Sustained Improvement in Pain with Talar OsteoPeriostic Grafting from the Iliac Crest (TOPIC) for Medial Osteochondral Lesions of the Talus: A Concise 5-Year Follow-up of a Previous Report.
Hollander JJ, Dahmen J, Stufkens SAS, Kerkhoffs GMMJ
Topics
Key Takeaway
TOPIC grafting for medial OLT maintained significant pain reduction at 5 years, with VAS pain scores improving from 6.8 to 2.1 (mean improvement 4.7 points) and 80% of patients reporting satisfaction.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This study reports 5-year outcomes of the TOPIC procedure (talar osteoperiostic grafting from the iliac crest) for medial osteochondral lesions of the talus, following up a prior cohort. VAS pain scores improved from 6.8 to 2.1 at 5 years, with 80% patient satisfaction, demonstrating durable pain relief. The procedure addresses large or complex medial lesions where bone marrow stimulation has limited efficacy.
Key Limitation
Absence of a comparator group (BMS, scaffold, or allograft) makes it impossible to attribute outcomes specifically to the TOPIC technique versus natural history or regression to the mean.
Original Abstract
Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.