Abstract
Objective: to investigate the long-term clinical and radiological outcome of talar avascular necrosis after treatment by a patellar-tendon bearing brace (PTB), and if parameters predictive for a positive or negative outcome could be identified.
Patients and methods: 21 patients were reviewed retrospectively, 10 had a non-traumatic origin and 11 a traumatic one (groups comparable to gender and age). Mean follow-up was 5,5 and 6,3 years, respectively; mean use of the PTB was 17,2 and 14,8 months. Clinical outcome was assessed by the Mazur scale and the Kitaoka score for function, and a VAS for pain and subjective satisfaction; radiological outcome by the Ficat & Arlet classification and by the Kellgren scale. Clinical parameters were analysed for their positive or negative predictive value on outcome.
Results: A very early pain control was achieved in both groups (2.1 versus 1.9 weeks). On both the Mazur scale and the Kitaoka score the non-traumatic group scored lower as the posttraumatic group (66,3 versus 77,6 and 76.1 versus 78.1). Both VAS were similar in both groups: 3,1 and 3,6 for pain and 6,8 and 7,1 for satisfaction. The need for analgesic medication was slightly higher in the non-traumatic group: 4 versus 3 patients. Radiologically both groups showed a similar outcome with both evaluation systems. Older age, delay in treatment, corticosteroids, alcohol, hyperlipidaemia and female gender were identified as negative predictive parameters.
Conclusions: A PTB is an efficient treatment for talar avascular necrosis of both non-traumatic and traumatic origin. Clinical outcome is better in the posttraumatic group, although radiological outcome is comparable. Only negative predictive parameters could be identified.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
