Initial results of arthroscopic surgery for osteochondral lesions of the talus using a hyaluronic acid-based scaffold with microfracture

Abstract

Introduction: Osteochondral Lesions of the Talus (OLT) is a rare disease in Vietnam, often overlooked in medical facilities. There are many methods of treatment, including ankle arthroscopy. Patients and Methods: The first six patients with OLT underwent arthroscopic hyaluronic acid-based scaffold implantation with microfracture surgery in Viet Duc University Hospital in Vietnam. Three patients have been followed in 6 months using the AOFAS score and MRI. Results: 5/6 patients were men aged between 30 and 40 years old and they play sports regularly. All the patients have passed the other hospital for pain in the ankle with no exact diagnosis. Examination for other symptoms, such as abnormal gait, ankle range of motion, ankle stability, or axial ankle deformity, were all negative. Six months after surgery, the AOFAS score in 3 patients improved from 57 and 61 to 91 and 100 points. MRI evaluation six months after surgery showed almost complete coverage of the artificial cartilage on the lesion surface. Conclusion and recommendation: Arthroscopy using hyaluronic acid-based scaffold implantation with microfracture to treat the OLT initially brought positive results, helping patients improve pain symptoms and return to daily life. However, in the future, more studies with longer follow-up times are needed to evaluate the results of this method. Keywords: arthroscopy, chondral lesions of the talus, hyaluronic acid-based scaffold, mesenchymal stem cells, microfracture.