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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-04-2016 | Ankle

Computed tomography analysis of osteochondral defects of the talus after arthroscopic debridement and microfracture

Authors: M. L. Reilingh, C. J. A. van Bergen, L. Blankevoort, R. M. Gerards, I. C. M. van Eekeren, G. M. M. J. Kerkhoffs, C. N. van Dijk

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2016

Abstract

Purpose

The primary surgical treatment of osteochondral defects (OCD) of the talus is arthroscopic debridement and microfracture. Healing of the subchondral bone is important because it affects cartilage repair and thus plays a role in pathogenesis of osteoarthritis. The purpose of this study was to evaluate the dimensional changes and bony healing of talar OCDs after arthroscopic debridement and microfracture.

Methods

Fifty-eight patients with a talar OCD were treated with arthroscopic debridement and microfracture. Computed tomography (CT) scans were obtained at baseline, 2 weeks postoperatively, and 1 year postoperatively. Three-dimensional changes and bony healing were analysed on CT scans. Additionally, clinical outcome was measured with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and numeric rating scales (NRS) for pain.

Results

Average OCD size increased significantly (p < 0.001) in all directions from 8.6 (SD 3.6) × 6.3 (SD 2.6) × 4.8 (SD 2.3) mm (anterior–posterior × medial–lateral × depth) preoperatively to 11.3 (SD 3.4) × 7.9 (SD 2.8) × 5.8 (SD 2.3) mm 2 weeks postoperatively. At 1-year follow-up, average defect size was 8.3 (SD 4.2) × 5.7 (SD 3.0) × 3.6 (SD 2.4) mm. Only average defect depth decreased significantly (p < 0.001) from preoperative to 1 year postoperative. Fourteen of the 58 OCDs were well healed. No significant differences in the AOFAS and NRS-pain were found between the well and poorly healed OCDs.

Conclusion

Arthroscopic debridement and microfracture of a talar OCD leads to an increased defect size on the direct postoperative CT scan but restores at 1-year follow-up. Only fourteen of the 58 OCDs were filled up completely, but no differences were found between the clinical outcomes and defect healing at 1-year follow-up.

Level of evidence

IV.

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Title: Computed tomography analysis of osteochondral defects of the talus after arthroscopic debridement and microfracture
Authors: M. L. Reilingh
C. J. A. van Bergen
L. Blankevoort
R. M. Gerards
I. C. M. van Eekeren
G. M. M. J. Kerkhoffs
C. N. van Dijk
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-015-3928-6

At a glance: The STEP trials

Springer Medicine

Computed tomography analysis of osteochondral defects of the talus after arthroscopic debridement and microfracture

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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