Abstract
Aim
To assess the results of arthroscopic treatment of osteochondral lesions of the talus and identify factors associated with a poor outcome.
Materials and Methods
Sixty patients (44 male, 16 female) with an average age at operation of 34 years(14 to 72 years) were reviewed after an average of 42 months(6 to 99 months). Patients were graded according to the criteria of Berndt and Harty1. Pre-operative radiographs and MRIs were graded according to Anderson et al2 and Hepple et al3 respectively. Forty-one lesions were medial, 31 of which were traumatic and 19 were lateral, all of which were traumatic. Thirty-four patients were treated with excision and curettage, 22 by excision and drilling, 2 by internal fixation and 2 by bone grafting.
Results
Thirty-one patients achieved a good outcome, 16 fair and 13 poor. Of the 13 poor results, 12 were medial lesions. Medial lesions presented later than lateral lesions (three years compared with 18 months) and almost 50% demonstrated cystic change on radiographs and MRI whereas only one lateral lesion demonstrated such changes. Outcome was not associated with patient age and no difference was found between traumatic and atraumatic medial lesions.
Conclusion
Most osteochondral lesions are well served by conventional treatment. However cystic lesions, usually of the medial aspect of the talus, do represent a therapeutic challenge.
The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.
References
1 Berndt AL, Harty M. JBJS1959, 41-A:988–1020 Google Scholar
2 Anderson IF et al. JBJS1989, 71-A:1143–1152 Google Scholar
3 Hepple S et al. Foot & Ankle Int1999, 20(12):789–793 Google Scholar
