Gökhan Polat1, Ali Erşen2, Mehmet Emin Erdil3, Taha Kızılkurt2, Önder Kılıçoğlu2, Mehmet Aşık2. 1. Department of Orthopaedics and Traumatology, Istanbul Medical Faculty, Istanbul University, Çapa, 34390, Istanbul, Turkey. gokhanpolat7@gmail.com. 2. Department of Orthopaedics and Traumatology, Istanbul Medical Faculty, Istanbul University, Çapa, 34390, Istanbul, Turkey. 3. Department of Orthopaedics and Traumatology, Istanbul Medipol University, Bağcılar, 34150, Istanbul, Turkey.
Abstract
PURPOSE: Osteochondral lesions of the talus are common injuries, and many clinicians consider arthroscopic debridement and microfracture as the first-stage treatment. This study assessed the long-term clinical and radiographic outcomes of arthroscopic debridement and microfracture for osteochondral lesions of the talus. METHODS: A total of 82 patients (48 males, 34 females) who were treated with arthroscopic debridement and microfracture for osteochondral lesions of the talus between 1996 and 2009 with a minimum 5-year follow-up were included in our study group. Functional scores (AOFAS, VAS) and ankle range of motion were determined, and an arthrosis evaluation was performed. Subgroup evaluations based on age, lesion localization, and defect size were performed using functional outcome correlations. RESULTS: The mean age of the patients was 35.9 ± 13.4 years (14-69 years), and the mean follow-up period was 121.3 months (61-217 months). The mean defect size was 1.7 ± 0.7 cm2 (0.25-5). The mean pre-operative AOFAS score was 58.7 ± 5.2 (49-75), and the mean post-operative AOFAS score was 85.5 ± 9.9 (56-100). At the last follow-up, 35 patients (42.6%) had no symptoms and 19 patients (23.1%) had pain after walking more than 2 h or after competitive sports activities. Radiological assessments of arthrosis revealed that no patient had grade 4 arthritis but that 27 patients (32.9%) had a one-stage increase in their arthrosis level. Subgroup analyses of the lesion location demonstrated that lateral lesions had significantly better functional results (p = 0.02). CONCLUSIONS: Arthroscopic debridement and microfracture provide a good option for the treatment of osteochondral lesions of the talus over the long term in select patients. Functional outcomes do not correlate with defect size or patient age. Orthopaedic surgeons should adopt the microfracture technique, which is minimally invasive and effective for treating osteochondral lesions of the talus. LEVEL OF EVIDENCE: IV.
PURPOSE:Osteochondral lesions of the talus are common injuries, and many clinicians consider arthroscopic debridement and microfracture as the first-stage treatment. This study assessed the long-term clinical and radiographic outcomes of arthroscopic debridement and microfracture for osteochondral lesions of the talus. METHODS: A total of 82 patients (48 males, 34 females) who were treated with arthroscopic debridement and microfracture for osteochondral lesions of the talus between 1996 and 2009 with a minimum 5-year follow-up were included in our study group. Functional scores (AOFAS, VAS) and ankle range of motion were determined, and an arthrosis evaluation was performed. Subgroup evaluations based on age, lesion localization, and defect size were performed using functional outcome correlations. RESULTS: The mean age of the patients was 35.9 ± 13.4 years (14-69 years), and the mean follow-up period was 121.3 months (61-217 months). The mean defect size was 1.7 ± 0.7 cm2 (0.25-5). The mean pre-operative AOFAS score was 58.7 ± 5.2 (49-75), and the mean post-operative AOFAS score was 85.5 ± 9.9 (56-100). At the last follow-up, 35 patients (42.6%) had no symptoms and 19 patients (23.1%) had pain after walking more than 2 h or after competitive sports activities. Radiological assessments of arthrosis revealed that no patient had grade 4 arthritis but that 27 patients (32.9%) had a one-stage increase in their arthrosis level. Subgroup analyses of the lesion location demonstrated that lateral lesions had significantly better functional results (p = 0.02). CONCLUSIONS: Arthroscopic debridement and microfracture provide a good option for the treatment of osteochondral lesions of the talus over the long term in select patients. Functional outcomes do not correlate with defect size or patient age. Orthopaedic surgeons should adopt the microfracture technique, which is minimally invasive and effective for treating osteochondral lesions of the talus. LEVEL OF EVIDENCE: IV.
Authors: Peter Cornelius Kreuz; Matthias Steinwachs; Christoph Erggelet; Andreas Lahm; Philipp Henle; Philipp Niemeyer Journal: Am J Sports Med Date: 2005-09-12 Impact factor: 6.202
Authors: Christiaan J A van Bergen; Laura S Kox; Mario Maas; Inger N Sierevelt; Gino M M J Kerkhoffs; C Niek van Dijk Journal: J Bone Joint Surg Am Date: 2013-03-20 Impact factor: 5.284
Authors: S I Correia; H Pereira; J Silva-Correia; C N Van Dijk; J Espregueira-Mendes; J M Oliveira; R L Reis Journal: J R Soc Interface Date: 2013-12-18 Impact factor: 4.118
Authors: Juan Manuel López-Alcorocho; Isabel Guillén-Vicente; Elena Rodríguez-Iñigo; Ramón Navarro; Rosa Caballero-Santos; Marta Guillén-Vicente; Mercedes Casqueiro; Tomás F Fernández-Jaén; Fernando Sanz; Santiago Arauz; Steve Abelow; Pedro Guillén-García Journal: Cartilage Date: 2019-03-17 Impact factor: 4.634
Authors: Michael M Chau; Mikhail A Klimstra; Kelsey L Wise; Jutta M Ellermann; Ferenc Tóth; Cathy S Carlson; Bradley J Nelson; Marc A Tompkins Journal: J Bone Joint Surg Am Date: 2021-06-16 Impact factor: 6.558