Arthroscopic Bone Marrow Stimulation or Non-Operative Treatment for Osteochondral Lesions of the Tibial Plafond

Abstract

Category:Ankle; ArthroscopyIntroduction/Purpose:A paucity of clinical results from osteochondral lesion of the tibial plafond (OLTP) treatment exists in the literature. The primary purpose of this study was therefore to compare the patient reported outcomes of OLTPs treated with arthroscopic bone marrow stimulation (BMS) and non-operative treatment. The secondary purpose was to compare the reintervention- and complication rates.Methods:Patients treated either with BMS (BMS group) or any form of non-operative treatment (non-operative group) at a minimum follow-up of 12 months were selected from a retrospective database query of patients treated between 1990 and 2020. Eligible patients were contacted by phone and cross-sectionally included. The primary outcome was the Numeric Rating Scale (NRS) during weightbearing. Secondary outcomes included; the NRS in rest, the Foot and Ankle Outcome Score (FAOS), and the Short Form Health Survey (SF-36) general health questionnaire. Additionally, the reintervention- and complication rates were collected.Results:A total of 55 patients were included, which consisted of 15 patients for the non-operative group and 40 patients for the BMS group were analyzed at a mean 73.2 +- 62.9 and 100.5 +- 72.1 months respectively (Table 1). The median NRS during weightbearing was 2 (IQR: 1-5) for the non-operative group and 1.5 (IQR: 0-4) for the BMS group (P= 0.43). The NRS in rest was, similarly, not significantly different between groups. None of the FAOS subscales were found to be significantly different between treatment groups. No reoperations or major complications after follow-up treatment were recorded.Conclusion:Clinical outcomes following arthroscopic BMS and non-operative treatment yield moderate to good clinical results in this cross-sectional cohort OLTP patients. Although this study was the first to report outcomes of non-operative treatment of OLTPs and to compare these to BMS, prospective studies are highly needed for these understudied lesions.