Abstract
PurposeOsteochondral defects (OCD) often have a severe impact on the quality of life due to deep ankle pain during and after weight bearing, which prevents young patients from leading an active life. Arthroscopic debridement and bone marrow stimulation are currently the gold standard treatment. The purpose of this study was to evaluate the number of patients that resume and maintain sports to their pre-injury activity level after arthroscopic debridement and bone marrow stimulation.MethodsThis retrospective study evaluated patients treated with arthroscopic debridement and bone marrow stimulation between 1989 and 2008. All patients who were participating in sports before injury were included. The Ankle Activity Scale (AAS) was used to determine activity levels during specific time points (before injury, before operation, after operation and at the time of final follow-up).ResultsNinety-three patients were included. Fifty-seven (76 %) patients continued participating in sports at final follow-up. The median AAS before injury of 8 (range 3–10) significantly decreased to 4 (range 2–10) at final follow-up.ConclusionIt is shown that 76 % of the patients were able to return to sports at long-term follow-up after arthroscopic debridement and bone marrow stimulation of talar OCDs. The activity level decreased at long-term follow-up and never reached the level of that before injury. The data of our study can be of importance to inform future patients on expectations after debridement and bone marrow stimulation of a talar OCD.Level of evidenceRetrospective case series, Level IV.
Highlights
Osteochondral talar defects (OCDs) are common after an ankle distortion [20]
OCDs can have a severe impact on the quality of life due to deep ankle pain during and after weight bearing [17]
The primary surgical treatment for OCDs up to 15 mm consists of arthroscopic debridement and bone marrow stimulation with an overall success rate of 85 %, lasting over the years to have a 76 % satisfactory outcome at long term [14, 15, 19]
Summary
Osteochondral talar defects (OCDs) are common after an ankle distortion [20]. Approximately 50 % of ankle sprains and fractures are associated with an OCD [10, 16]. OCDs can have a severe impact on the quality of life due to deep ankle pain during and after weight bearing [17]. If these defects are left untreated, patients are unable to live an active life [8, 20]. The primary surgical treatment for OCDs up to 15 mm consists of arthroscopic debridement and bone marrow stimulation with an overall success rate of 85 %, lasting over the years to have a 76 % satisfactory outcome at long term [14, 15, 19].
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