J Korean Orthop Assoc.  2010 Dec;45(6):433-439. 10.4055/jkoa.2010.45.6.433.

Arthroscopic Treatment for Cartilage Lesions of the Talus

Affiliations
  • 1Department of Orthopedic Surgery, Pusan Paik Hospital, College of Medicine, Inje University, Busan, Korea. kimjh8142@hanmail.net

Abstract

PURPOSE
To compare clinical results and to evaluate the factors affecting the clinical results after performing arthroscopic chondroplasty, microfracture, and osteochondral autologus transplantation (OAT) due to a chondral defect of the talus.
MATERIALS AND METHODS
This study enrolled 35 patients (36 cases) diagnosed with a chondral defect of the talus and who could be followed over 12 months after arthroscopic chondroplasty, microfracture, or OAT between March 1998 and December 2007. The arthroscopic chondroplasties were carried out in 14 cases (13 patients), the microfractures were carried out in 12 cases (12 patients) and OAT was carried out in 10 cases (10 patients). The lesion staging used Berndt and Harty classification on simple radiographs and Anderson's classification on magnetic resonance images. Clinical results were evaluated and compared by measuring VAS and AOFAS scores at the time of operation, before the operation, and at the time of follow up. Clinical evaluation included location, size, and stage of each lesion as well as the age of individual patient.
RESULTS
There were 13 medial and 23 lateral lesions. The average size of the chondral defects were 1.9 cm2 (range: 1-4 cm2). According to the classification of Berndt and Harty and Anderson, there were 8 stage II, 21 stage III, and 7 stage IV cases. The average follow up period was 15 months (range: 12-30 months). VAS and AOFAS scores showed significant improvement in all treatment groups. However, clinical results according to the operative methods did not show any differences. Lesion size, stage and location, as well as of age of patient had no significant impact on clinical results.
CONCLUSION
We concluded that all three procedures, arthroscopic chondroplasty, microfracture, and OAT, are useful for treating a chondral defect of talus. Location of lesion, size, stage and age of patient did not make a significant difference.

Keyword

talus; chondral defect; arthroscopy
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