THE ROLE OF ARTHROSCOPIC DRILLING FOR OSTEOCONDRAL LESIONS OF THE TALUS

Abstract

Objective: To evaluate the outcome of arthroscopic drilling for the treatment of osteochondral lesion of talus.
Patients and methods: Eleven (six males and five females) patients with a symptomatic osteochondral lesion of the talus were operated with arthroscopic drilling. They were followed postoperatively for ten to ninety-six months (mean, 39 months) The mean age of the patients was 27 years (range, 17-40 years). There were six lesions on the anteriomedial aspect of the talus, the three anteriolaterally and two posteriomedially. According to the radiographic classification system of Berndt and Harty, seven ankles had Stage II lesions, two had Stage III and two had Stage IV. The lesions were also classified according to the their arthroscopic appearance by using Outerbridge classification. Arthroscopic debridement and drilling were performed in Stage III and IV lesions. Stage II lesions were treated with arthroscopic drilling only. The outcome was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) score.
Results: The average preoperative AOFAS score of 66 points (46 to 74) improved to 87 points (78 to 97) at the last follow-up. The radiographic findings showed that four lesions were improved, six lesions were unchanged and the only one stage IV lesion was deteriorated.
Discussion: Arthroscopic drilling for the treatment of the osteochondral lesions of the talus is an effective and useful method. However, the improvement of clinical outcome is not always accompanied with radiological improvement.