The subchondral bone healing after fixation of an osteochondral talar defect is superior in comparison with microfractureReport as inadecuate




The subchondral bone healing after fixation of an osteochondral talar defect is superior in comparison with microfracture - Download this document for free, or read online. Document in PDF available to download.

Knee Surgery, Sports Traumatology, Arthroscopy

pp 1–6

First Online: 27 July 2017Received: 07 April 2017Accepted: 19 July 2017

Abstract

PurposeArthroscopic bone marrow stimulation BMS has been considered the primary surgical treatment for osteochondral defects OCDs of the talus. However, fixation has been considered as a good alternative. Recently, a new arthroscopic fixation technique was described: the lift, drill, fill and fix procedure LDFF. The purpose of this study was to evaluate the clinical and radiological results between arthroscopic LDFF and arthroscopic BMS in primary fixable talar OCDs at 1-year follow-up.

MethodsIn a prospective comparative study, 14 patients were treated with arthroscopic BMS and 14 patients with arthroscopic LDFF. Pre- and postoperative clinical assessment included the American Orthopaedic Foot and Ankle Society AOFAS score and the numeric rating scales NRSs of pain at rest and running. Additionally, the level of the subchondral plate flush or depressed was analysed on the 1 year postoperative computed tomography scans.

ResultsNo significant differences in the AOFAS and NRS pain at rest and running were found between both groups at 1-year follow-up. After LDFF the level of the subchondral bone plate was flush in 10 patients and after BMS in three patients p = 0.02.

ConclusionNo clinical differences were found between arthroscopic LDFF and arthroscopic BMS in the treatment of talar OCDs at 1-year follow-up. However, the subchondral bone plate restores significantly superior after arthroscopic LDFF compared to arthroscopic BMS. It may therefore give less progression of ankle osteoarthritis in the future with a thus potential better long-term outcome.

Level of evidenceIII.

KeywordsAnkle Osteochondral defects Arthroscopy Microfracture Bone marrow stimulation Fixation Lift, drill, fill and fix LDFF  Download fulltext PDF



Author: Mikel L. Reilingh - Kaj T. A. Lambers - Jari Dahmen - Kim T. M. Opdam - Gino M. M. J. Kerkhoffs

Source: https://link.springer.com/



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