Non-Operative Treatment for Symptomatic Osteochondral Lesion of the Talus

Abstract

Purpose: Although reports on operative treatment of osteochondral lesion of the talus (OLT) are increasing, to the best of our knowledge, there have been only a few reports on non-operative treatment of OLT. The purpose of this study is to report the prognosis of non-operative treatment for OLT patients. Materials and Methods: This retrospective study included 104 patients (57 male, 47 female) with OLTs having a follow-up period of more than two years, between 2003 and 2013. The location, size, and stage of the OLT were confirmed by magnetic resonance imaging or computed tomography. At the final follow-up, simple radiographs confirmed the progression of osteoarthritis. We surveyed the limitations of sports activity, visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) scale, and SF-36. Results: There were no patients with progression of osteoarthritis at the final follow-up. Only two patients (2.4%) complained the limitation of desired sports activity. The mean VAS significantly decreased from 4.3 (range, 0-8) to 1.1 (range, 0-4) (p＜0.001). The mean AOFAS scale significantly improved from 83.3 (range, 41-100) to 92.5 (range, 65-100). Moreover, the mean SF-36 also improved from 52.6 (range, 30.0–91.0) to 72.9 (range, 40.6-97.0) (p＜0.001). Conclusion: Sufficient non-operative treatment is initially recommended to OLT patients because pain, in general, improves in most cases despite the presence of symptoms. Moreover, it’s worth noting that the progression to osteoarthritis is rare.