Arthroscopic Treatment of Osteochondral Lesions of the Talus

Abstract

Objective: To assess pain and function of the ankle in patients with injuries up to 1.5 cm diameter by the American Orthopaedic Foot and Ankle Society (AOFAS) score after arthroscopic treatment. Methods: The AOFAS scale was applied before and after arthroscopy, as well as the degree of subjective satisfaction of ambulatory patients. Patients with type I osteochondral injuries, acute trauma, using plaster, presenting lesions in other joints of the lower limbs and cognitive impairment that would prevent the application of the satisfaction questionnaire were excluded from the study. Statistical analysis was performed using unpaired t test with Welch correction, Mann Whitney test, and ANOVA, with Kruskal Wallis test and Dun test, considering p value lower than 0.05. Results: There was an increased AOFAS scores after arthroscopic treatment in 52 (94.5%) patients. The mean values of AOFAS score in 55 patients was 77.32 ± 6.67 points preoperative and 93.10± 8.24 points postoperative, with a mean variation of 15.8 points, p<0.001. Patients with stage II, III and IV injuries showed an increased AOFAS scores after arthroscopic treatment, p<0.001. No difference was found between medial and lateral injuries, p >0.05. Conclusion: Patients with stage II, III or IV osteochondral injuries of the talus of up to 1.5 cm diameter, whether medial or lateral, showed a significant improvement after arthroscopic treatment. Level of Evidence III, Retrospective Study.

Location Distribution of 2,087 Osteochondral Lesions of the Talus

“…After full-text screening, 51 studies were included. 2 , 11 - 60 There was an overall consensus in all cases of article selection between the first 2 authors.…”

The Impact of Weight on Arthroscopic Osteochondral Talar Reconstruction

“…Focal osteochondral defects of the talus are commonly seen with ankle arthroscopy. 9 The talar dome is a common location for osteochondral lesions (OLTs), exceeded in frequency only by the knee, and the elbow. 25 Approximately 1 in 10 000 people per day has an ankle injury.…”

High reported rate of return to play following bone marrow stimulation for osteochondral lesions of the talus

“…Fifty‐seven clinical studies reporting return to play and/or rehabilitation guidelines with 3072 ankles were included (LOE I: 4, LOE II: 6, LOE III: 9, LOE IV: 38) [2–5, 7–12, 14–29, 32–43, 45, 47, 50, 52, 53, 55, 56, 59–64, 66–70, 72, 73]. There were 1858 males and 1125 females, with a mean weighted age of 36.9 years (range 23–56.8) followed up at a mean of 46.0 months (range 1.5–141).…”