Effects of Early Weightbearing on Microfracture Treatment of Osteochondral Lesions of Talus with Subchondral Bone Defects

Abstract

When subchondral bone defects are present in osteochondral lesions of the talus (OCLT), it is inconclusive whether to allow early weightbearing after microfracture treatment because of the lack of effective support of the newly-formed fibrocartilage. After performing arthroscopic debridement and microfracture treatment on OCLT patients with subchondral bone defects, we allowed patients to have an early postoperative weightbearing exercise to observe their clinical outcome. Forty-two OCLT patients with subchondral bone defects were analyzed. Patients were randomly divided into two groups with 21 patients in each group. After arthroscopic debridement and microfracture treatment, group A was allowed to have early partial weightbearing while weightbearing was delayed in group B. Visual analogue scale (VAS) was used to evaluate joint pain before and after surgery. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to evaluate joint function. Tegner activity scale was used to assess patient’s exercise level. The AOFAS ankle-hindfoot score in group A increased from 54.4 to 87.6, and that in group B increased from 54.9 to 87.3. The VAS score in group A decreased from 6.5 to 2.2, and that in group B decreased from 6.4 to 2.3. The Tegner activity scale increased from 2.6 to 4.4 in group A, and that in group B increased from 2.6 to 3.9. There was significant difference in the Tegner activity scale between group A and group B (P<0.05). It was suggested that when performing microfracture treatment on OCLT patients with subchondral bone defects, early postoperative weightbearing may achieve similar clinical outcomes as delayed weightbearing, and patients may be better able to return to sports.