The results of arthroscopic treatment for talus osteochondral lesions

Abstract

DOI: 10.4328/JCAM.5919 Received: 04.06.2018 Accepted: 08.10.2018 Published Online: 09.10.2018 Printed: 01.05.2019 J Clin Anal Med 2019;10(3): 359-64 Corresponding Author: Azad Yıldırım Diyarlife Dağ Kapı, Diyarbakır Hospital, Diyarbakır, Turkey. E-Mail: yildirimazad@gmail.com ORCID ID: 0000-0001-7058-4476 Abstract Aim: Our aim is to share the mid-term results of debritment and marrow bone stimulation proccess in patients with talus OCD who did not respond to the conservative treatment. Material and Method: The patients with talus osteochondritis dissecans weretreated by arthroscopic debridement; and bone marrow stimulation was performed with Kwire. Twenty-sixof 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. Results: A 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 month (mean 34,3). The individual analysis results showed that the pre-operative AOFAS scores were significantly different between the primary and the revision groups, while post-operative scores were not significantly different between the primary and therevision groups. For the whole group, the AOFAS skore 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 four (15) and excellent in eight (31) patients, while in the revision group they were good in eleven (73%), fair in two (13%) and poor in one (7%) patient. The combined good and excellent scores were 85% for the primary group and 80% for the revision group. The mean AOFAS AHS score at the 12th month was 88.2 in the primary group and 82.8 in the revision group. Discussion: Arthroscopic curettage and bone marrow stimulating process is a viable method and recommended for both primary and revision treatment of an osteochonditis dissecans of the talus.