Clinical Outcome of Surgical Treatment for Osteochondral Lesions of the Talus

Clinical Outcome of Surgical Treatment for Osteochondral Lesions of the Talus

Assess clinical and radiological outcome of the various surgical techniques for treatment of osteochondral lesions of the talus

Osteochondritis dissecans (OCD) of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. Osteochondral lesions of the talus (OLT) are frequent after acute ankle trauma. The natural history of the OLT remains unclear due to paucity of longitudinal follow-up studies. Various treatment strategies have been described for OLT, including conservative treatment and operative treatment However, the current literature does not allow firm evidence-based recommendations concerning the treatment to be established ; Microfracture is the most common reparative surgery for osteochondral lesions of the talus (OLTs). While shown to be effective in short- to midterm outcomes, the fibrocartilage that microfracture produces is both biomechanically and biologically inferior to that of native hyaline cartilage and is susceptible to possible deterioration over time following repair . Arthroscopic debridement (AD) for the osteochondral lesions of the talar dome (OLT) was widely documented in the nineties with satisfactory results. However, in modern treatment algorithms, its role is not described. A frequently used instrument for assessing outcome after ankle and hindfoot injuries is the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score .

Inclusion Criteria:

• Age from 15 to 60 years old.
• Traumatic and degenerative etiology.
• without ankle deformity.
• No inflammatory arthritis.
• Absent or corrected ligamentous instability

Exclusion Criteria:

• Older than 60 years old and younger than 15 years old.
• Charcot ankle.
• Vascular injury.