The results of arthroscopic treatmentfor talus osteochondral lesions

Abstract

AimOur aim is to share the mid-term results of debridement and marrow bone stimulation process in patients with talus OCD who did not respond to conservative treatment.MethodsPatients with talus osteochondritis dissecans were treated by arthroscopic debridement; and bone marrow stimulation was performed with K-wire. Twenty-six of them formed the primary and 15 of them formed the revision group. Clinical assessment included the Ogilvie-Harris score and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. The defects were classified according to the system of Berndt and Harty. The lesion side, symptom time, trauma history, age-related complication, Ogilvie-Harris and AOFAS scores, follow-up period, and well-being condition of the groups were compared.ResultsA total of 41 patients, 25 males and 16 females, with a mean age of 34.3 years (range 19–62), were included in the present study. Follow-up ranged from 23–73 months (mean 34.3). Pre-operative AOFAS scores were significantly different between the primary and revision groups, while post-operative scores were not significantly different. For the whole group, the AOFAS score was excellent in 9 patients, good in 25, fair in 6, and poor in one. In the primary group, the AOFAS scores were good in 14 (54%), fair in 4 (15%), and excellent in 8 (31%), while in the revision group they were good in 11 (73%), fair in 2 (13%), and poor in 1 (7%). Combined good and excellent scores were 85% for the primary group and 80% for the revision group. Mean AOFAS AHS score at the 12th month was 88.2 in the primary group and 82.8 in the revision group.ConclusionArthroscopic curettage and bone marrow stimulation is a viable method and recommended for both primary and revision treatment of an osteochondritis dissecans of the talus.

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