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Treatment of osteochondral lesions of the talus with microfracture technique and postoperative hyaluronan injection

  • Ankle
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study is to report the outcomes of the treatment of talar osteochondral lesions with arthroscopic microfracture technique and postoperative intra-articular hyaluronan injection.

Method

Fifty-seven patients (29 men, 28 women) with osteochondral lesions of the talus were included in this prospective randomized clinical study between the years 2003 and 2009. The patients were treated with arthroscopic debridement and microfracture technique. Randomly selected 41 patients were injected intra-articular hyaluronan (injection group). The remaining 16 patients did not receive postoperative injection (non-injection group). Assessment of the pain and functional outcomes was performed using the Freiburg and AOFAS ankle/hindfoot scoring systems.

Results

In the injection group, the mean postoperative Freiburg functional and pain scores were significantly higher compared to preoperative functional and pain scores (P < 0.001). Similarly, for the patients in non-injection group, the mean postoperative Freiburg functional and pain scores were significantly higher compared to preoperative functional and pain scores (P < 0.001). The AOFAS functional and pain scores of the patients in the injection group were significantly higher (P < 0.001) postoperatively compared to preoperative scores. Scoring the patients in the non-injection group according to AOFAS system also revealed significantly higher (P < 0.001) postoperative functional and pain scores over preoperative scores. The increase in the postoperative scores was found to be significantly higher in the injection group compared to non-injection group in both Freiburg and AOFAS systems (P < 0.001).

Conclusion

Treatment of osteochondral lesions of the talus using microfracture technique significantly improved functional and pain scores postoperatively. Additional treatment with intra-articular hyaluronan injection as an adjunct to microfracture technique may offer better clinical outcomes over microfracture technique alone.

Level of evidence

Randomized, controlled trial, Level I.

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Conflict of interest

No benefits in any form have been received or will be received from any people or any commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    M. N. Doral, G. Batmaz, O. A. Atay & A. Uzumcugil

  2. Department of Orthopaedics and Traumatology, Meram Faculty of Medicine, Selcuk University, Konya, Turkey

    O. Bilge

  3. Institute of Medical Science, University of Toronto, Toronto, ON, Canada

    K. Atesok

  4. Department of Sports Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    M. N. Doral, G. Donmez & D. Kaya

  5. Department of Orthopaedics and Traumatology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey

    E. Turhan

  6. Department of Orthopaedics and Traumatology, Bayindir Hospital, Ankara, Turkey

    M. Demirel

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  1. M. N. Doral
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  2. O. Bilge
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  3. G. Batmaz
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  8. A. Uzumcugil
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  10. D. Kaya
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Correspondence to M. N. Doral.

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Doral, M.N., Bilge, O., Batmaz, G. et al. Treatment of osteochondral lesions of the talus with microfracture technique and postoperative hyaluronan injection. Knee Surg Sports Traumatol Arthrosc 20, 1398–1403 (2012). https://doi.org/10.1007/s00167-011-1856-7

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