A novel retrograde technique for ankle osteochodral lesions: the sub-endo-chondral regenerative treatment (secret)

Faldini, Cesare; Mazzotti, Antonio; Artioli, Elena; Ruffilli, A; Barile, Francesca; Zielli, Simone Ottavio; Geraci, Giuseppe

doi:10.1007/s12306-022-00767-6

Cited by 6 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The literature concerning RD was mostly constituted by retrospective case series (17 articles, 81%) [ 6 , 8 , 12 – 26 ], classified as LOE IV. The remaining articles were equally divided into retrospective comparative studies (two articles, 10%) [ 7 , 27 ] and prospective observational studies (two articles, 10%) [ 28 , 29 ], both classified as LOE III (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Seven articles reported the mean size of the lesions, but in different ways [ 6 , 8 , 12 , 16 , 17 , 28 , 29 ]. To compare most of the articles, only the mean length of the lesions was considered; it was found to be 11.4 mm (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Among the clinical and radiological parameters used in assessing surgical indication, 15 authors agreed that intact cartilage must be present to make patients eligible for RD [ 7 , 8 , 12 , 14 , 16 – 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding lesion size, only two authors set a threshold value to consider surgery, which ranged from 100 mm 2 to 125 mm 2 [ 7 , 28 ]. Faldini et al also extended surgical indication to wide osteochondral lesions with, theoretically, no size limit [ 8 ].…”

Section: Resultsmentioning

confidence: 99%

“…Despite its wide application, current evidence on the indications for and outcomes of RD in the treatment of osteochondral lesions of the ankle is limited, and a comprehensive review is missing. Moreover, in the last few years there has been some evolution of the original technique [ 6 – 8 ]. Since RD has provided better results compared to anterograde drilling [ 9 ], and the latter is being progressively replaced by microfractures that do not cause heat damage, this review focuses only on RD.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Retrograde drilling for ankle joint osteochondral lesions: a systematic review

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background Extensive literature exists about the treatment of ankle osteochondral lesions, but there is no specific review of retrograde drilling, despite its common application. Indications for retrograde drilling are still few and are far from clear, and some evolutions of the technique have recently occurred. The aim of this review is to provide an update on actual applications and techniques of retrograde drilling for ankle osteochondral lesions. Methods A systematic review was carried out according to the 2020 PRISMA guidelines. The PubMed and Embase databases were searched in June 2023. The search string focused on studies related to retrograde drilling in the treatment of ankle osteochondral lesions. Results Twenty-one articles for a total of 271 ankles were included in this review. The mean length of the treated lesions was 11.4 mm. Different navigation systems were used, with fluoroscopy the most commonly used. Various adjuvants were employed after drilling, with bone graft the most commonly applied. In most cases, postoperative patient satisfaction and symptom relief were reported, and no complications occurred. Retrograde drilling was found to be suitable for the treatment of subchondral cysts with intact cartilage or small lesions. Some modifications to the original technique may allow surgical indications to be extended to more complex cases. Conclusions Middle-term results of retrograde drilling showed postoperative satisfaction and symptom relief with both original and modified techniques. Additional research is required to investigate the long-term results. Level of evidence: IV. Trial registration: This systematic review was registered on PROSPERO (id number: CRD42022371128).

show abstract