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Archives of Orthopaedic and Trauma Surgery

, Volume 132, Issue 12, pp 1765–1771 | Cite as

Clinical and MRI results after microfracture of osteochondral lesions of the talus

  • B. KuniEmail author
  • H. Schmitt
  • D. Chloridis
  • K. Ludwig
Arthroscopy and Sports Medicine

Abstract

Purpose

Arthroscopic microfracture (AM) of osteochondral lesions of the talus is used to induce intrinsic refilling of the defect and reduce pain. The aim of this retrospective study was to investigate the clinical state after AM and the MRI outcome.

Methods

A total of 22 patients [10 women, 12 men, 31 years old (mean, 13–68 range)] treated for osteochondral lesions of the talus by AM were examined 2 years (median) postoperatively and pre- and postoperative MRI results compared. Swelling/effusion, articular constriction, joint pain, and range of motion restriction were documented. Clinical state was evaluated using the AOFAS hindfoot score. MRI was used to assess the size of the defect, presence of bone marrow edema, cysts and effusion, thickness of repair tissue, and integrity of the cartilage.

Results

In all but six cases, the defect was located at the medial shoulder of the talus. The postoperative AOFAS score at follow-up was 87.5 points (median 36–100 points range). Seven patients were free of pain, 11 had “mild, occasional” pain, 1 “moderate daily”, and 3 “severe, almost always present” pain (AOFAS). The defect volume was significantly reduced from 377 mm3 preoperatively (median, interquartile distance: 417 mm3) to 249 mm3 postoperatively (median, IQD: 336 mm3, p = 0.019, Wilcoxon). In 7 cases, the defect was completely filled, in 11 partially and in 4 only slightly.

Conclusion

After AM of osteochondral lesions of the talus, 18 of 22 patients had no or mild, occasional pain at 2 years follow-up. On MRI, the lesion volume had been reduced and filling with repair tissue was found.

Keywords

Cartilage defect Osteochondral lesion Microfracture Ankle joint Talus MRI 

Notes

Acknowledgement

The authors would like to thank Sherryl Sundell for English grammar revision.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • B. Kuni
    • 1
    Email author
  • H. Schmitt
    • 1
    • 2
  • D. Chloridis
    • 1
  • K. Ludwig
    • 1
    • 3
  1. 1.Department of Orthopedics, Trauma Surgery and Spinal Cord InjuryClinic for Orthopedics and Trauma Surgery, Heidelberg University HospitalHeidelbergGermany
  2. 2.ATOS Klinik HeidelbergHeidelbergGermany
  3. 3.Department of Diagnostic and Interventional RadiologyKlinikum HerfordHerfordGermany

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