Autologous osteochondral graft as treatment for gouty tophus in the talus

摘要

Subcutaneous gouty tophiand chronic gouty arthritisarecaused by along-termhistory of hyperuricemia, which results in the deposition of monosodiumurate monohydrate(MSU)crystals in theskin, synoviumtissues in thejoint,cartilage,and bone,and thesurrounding soft tissues. [1] Furthermore, goutcan causeredness, swelling, local heat, severe pain,and alimitation offunction oftheaffected jointsand surrounding tissues. A number ofcomplex interacting processesareresponsiblefor the pathophysiology of gout:metabolic, genetic,and other factors that result in hyperuricemia; physiologic, metabolic,and othercharacteristics responsibleforcrystalformation;acuteinflammatory processesand the involvement ofcellularand solubleinflammatory and innateimmune processes. In addition, thesechronicinflammatory processesand effects of crystalsand immunecells on osteoclasts, osteoblasts,and chondrocytescontributeto theformation oftophi,and boneerosion,cartilageattrition and joint injury.