Microfracture For Osteochondral Lesions Research Articles

CT arthrography visualizes joint regeneration after microfracture of OLT

Category:Ankle, Arthroscopy, SportsIntroduction/Purpose:Little is known about arthroscopic or radiographic outcome after arthroscopic microfracture for osteochondral lesions of the talus (OLTs). The purpose of this study was to investigate tissue growth after arthroscopic microfracture for OLT using computed tomography arthrography (CTA) and to correlate this defect filling with clinical outcomes. We hypothesized that the morphology of the repaired tissue would be similar to that of normal anatomy and related to the clinical outcome.Methods:Forty-two ankles treated using arthroscopic microfracture for OLT from 2009 to 2014 were monitored. CTA was performed postoperatively at 6 months, 1, and 2 years. The postoperative thickness of the repaired tissue associated with OLT (grade) and the volume of the subchondral cystic lesions were evaluated using CTA. Clinical outcomes, including a pain visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle functional score, were evalua...

Outcomes of arthroscopic debridement and microfracture for osteochondral lesions of the talus

Outcomes of arthroscopic debridement and microfracture for osteochondral lesions of the talus

Outcome of Arthroscopic Debridement and Microfracture as the Primary Treatment for Osteochondral Lesions of the Talar Dome

The purpose of this systematic review was to determine patient outcomes after arthroscopic debridement and microfracture for osteochondral lesions (OCLs) of the talar dome. Infotrieve-PubMed/MEDLINE and Google Scholar were systematically searched for the following terms: microfracture AND ankle OR talus. In addition, we hand-searched common American and European orthopaedic and podiatric surgical journals for relevant manuscripts. Articles considered for inclusion were published in peer-reviewed journals, used the American Orthopaedic Foot & Ankle Society hindfoot scoring system for outcome measurement, and involved arthroscopic debridement and microfracture for OCL of the talar dome. We identified 29 potentially relevant publications, of which 7 met our inclusion criteria. A total of 295 patients (299 ankles) were included in this study. The weighted mean postoperative American Orthopaedic Foot & Ankle Society hindfoot score was 86.8 points, translating to good to excellent outcomes in 80.2% of patients. Many techniques exist for the treatment of OCLs of the talar dome. Good to excellent results can be consistently reached in greater than 80% of patients with arthroscopic debridement and microfracture. However, additional prospective trials should be undertaken to determine differences in outcome between techniques, size and location of the OCL, and other patient quality factors, such as cost and time to return to work. Level IV, systematic review of Level II, III, and IV studies.

In Which Position Do We Perform Arthroscopy of the Hindfoot—Supine or Prone?

Over the last twenty-five years, hindfoot arthroscopy has evolved from a diagnostic tool to a therapeutic modality used to treat many intra-articular disorders1,2. This procedure has always been performed with the patient in the supine position, utilizing the anteromedial, anterolateral, and posterolateral portals. The posteromedial portal was avoided because of difficult access and concerns about injury to the neurovascular structures. In the mid-1990s, van Dijk, Amendola, and others introduced the concept of posterior hindfoot arthroscopy (PHA) performed with the patient in the prone position3,4. This was stimulated by renewed interest in arthroscopically treating posterior ankle impingement, including removal of the os trigonum or Stieda process and other pathology. Since that time, there have been a number of reports on PHA, including its safety, indications, and results. As expertise with this procedure has improved, the indications for PHA have increased and include debridement and microfracture of osteochondral lesions of the talus, excision of the os trigonum, release of the flexor hallucis longus tendon, subtalar arthrodesis, and treatment of posttraumatic arthrofibrosis, calcaneal fractures, and Achilles tendon disorders5. However, …