Arthroscopic treatment for osteochondral lesions of the talus: analysis of outcome predictors

Abstract

Background: Compared with traditional arthrotomy procedures, arthroscopic treatment for osteochondral lesions of the talus has some advantages. However, there has been considerable debate about the outcome predictors for this surgical technique. This study aimed to investigate the outcomes of arthroscopic treatment for osteochondral lesions of the talus, and analyze its outcome predictors.

Methods: Clinical data of 48 patients with osteochondral lesions of the talus who underwent ankle arthroscopy were studied. Arthroscopic debridement was performed on all patients, and microfracture was also performed in 36 cases. Scores on a subjective satisfaction questionnaire, visual analog scale (VAS) for pain, and the American Orthopedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores were obtained before and after surgery.

Results: Five patients lost to follow up. The other forty-three patients, 8 of whom were athletes, were followed up for an average of 23.9 months. The average AOFAS post-operative score was 90.16 +/- 9.96, compared with 70.81 +/- 6.96 before surgery (t = 9.353, P < 0.001). The VAS pain score after the operation (2.51 +/- 2.45) was significantly lower than that before the operation (6.95 +/- 1.40) (t = 8.647, P < 0.001). Of the 43 patients, 35 (81.4%) had good or excellent results. There was no significant difference in outcome between the medial and lateral groups (z = 0.205, P = 0.838), while a better outcome was found with lesions smaller than 10 mm than those with larger lesions (z = 2.199, P = 0.028). Age, sex, athletic profession and location of the lesion did not significantly correlate with outcomes.

Conclusions: Arthroscopic treatment is effective and safe for osteochondral lesions of the talus. A strong correlation was found between the size of the lesion and successful outcome.