PURPOSE: The purpose of this study was to identify outcomes and outcome predictors of arthroscopic debridement with osteochondral bone stimulation (microfracture) for osteochondral lesions of the ankle. METHODS: One hundred five consecutive patients with osteochondral lesions of the ankle who underwent ankle arthroscopy with microfracture were prospectively followed up for a mean of 31.6 +/- 12.1 months. Study patients were evaluated at 6 weeks, 3 months, 6 months, 12 months, and annually after surgery. Assessments via a visual analog scale for pain during daily activities and sport activity, the Roles and Maudsley score, and the American Orthopaedic Foot & Ankle Society ankle and hindfoot scoring system were obtained at each visit. Outcome predictors were analyzed by logistic regression model. RESULTS: There were no failures of treatment with lesions smaller than 15 mm. In contrast, only 1 patient met the criteria for success in the group of lesions greater than 15 mm. Statistical analysis revealed that increasing age, higher body mass index, history of trauma, and presence of osteophytes negatively affected outcome. The presence of instability and the presence of anterolateral soft-tissue scar were correlated with a successful outcome. CONCLUSIONS: This study found a strong correlation between lesion size and success across its entire population. For lesions smaller than 15 mm, regardless of location, excellent results were obtained. In addition, increasing age, higher body mass index, history of trauma, and presence of osteophytes negatively affect outcome. The presence of instability and anterolateral soft-tissue scar correlated with a successful outcome. LEVEL OF EVIDENCE: Level IV, prognostic case series, prognostic study.
PURPOSE: The purpose of this study was to identify outcomes and outcome predictors of arthroscopic debridement with osteochondral bone stimulation (microfracture) for osteochondral lesions of the ankle. METHODS: One hundred five consecutive patients with osteochondral lesions of the ankle who underwent ankle arthroscopy with microfracture were prospectively followed up for a mean of 31.6 +/- 12.1 months. Study patients were evaluated at 6 weeks, 3 months, 6 months, 12 months, and annually after surgery. Assessments via a visual analog scale for pain during daily activities and sport activity, the Roles and Maudsley score, and the American Orthopaedic Foot & Ankle Society ankle and hindfoot scoring system were obtained at each visit. Outcome predictors were analyzed by logistic regression model. RESULTS: There were no failures of treatment with lesions smaller than 15 mm. In contrast, only 1 patient met the criteria for success in the group of lesions greater than 15 mm. Statistical analysis revealed that increasing age, higher body mass index, history of trauma, and presence of osteophytes negatively affected outcome. The presence of instability and the presence of anterolateral soft-tissue scar were correlated with a successful outcome. CONCLUSIONS: This study found a strong correlation between lesion size and success across its entire population. For lesions smaller than 15 mm, regardless of location, excellent results were obtained. In addition, increasing age, higher body mass index, history of trauma, and presence of osteophytes negatively affect outcome. The presence of instability and anterolateral soft-tissue scar correlated with a successful outcome. LEVEL OF EVIDENCE: Level IV, prognostic case series, prognostic study.
Authors: Raymond J Walls; Keir A Ross; Ethan J Fraser; Christopher W Hodgkins; Niall A Smyth; Christopher J Egan; James Calder; John G Kennedy Journal: World J Orthop Date: 2016-01-18
Authors: Christiaan J A van Bergen; Peter A J de Leeuw; C Niek van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2008-09-23 Impact factor: 4.342
Authors: Christiaan J A van Bergen; Leendert Blankevoort; Rob J de Haan; Inger N Sierevelt; Duncan E Meuffels; Pieter R N d'Hooghe; Rover Krips; Geert van Damme; C Niek van Dijk Journal: BMC Musculoskelet Disord Date: 2009-07-10 Impact factor: 2.362