Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2024; 91(4):234-238 | DOI: 10.55095/achot2024/031

Comparison of Arthroscopic Microfracture and Retrograde Subchondral Drilling in the Treatment of Osteochondral Lesions of Talus

U. O. KASMAN, Ö. KORKMAZ

Bahçeşehir University Medical School, Department of Orthopedics and Traumatology, VM Medicalpark Pendik Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey

Purpose of the study: In our study, it was aimed to evaluate the efficacy of microfracture and retrograde subchondral drilling on clinical outcomes in patients who underwent ankle arthroscopy due to osteochondral lesion of medial talus.

Material and methods: Twenty eight patients with osteochondral lesion of talus less than 1.5 cm² treated with ankle arthroscopy were evaluated retrospectively. Microfracture was performed in 16 patients and retrograde subchondral drilling was performed in 12 patients that there was no loss of integrity in the cartilage layer or cartilage layer is partially preserved during ankle arthroscopy. Postoperative evaluations of the patients were done with Foot and Ankle Ability Measure (FAAM) and results of both group were compared statistically.

Results: The mean activities of daily living scale was 93.4±3.2 and sportive activity scale was 90.1±5.7 in the retrograde drilling group. In the micro-fracture group, mean activities of daily living scale was 93.8±4.1 and mean sportive activity scale was 88.9±9.5. No significant difference was found as a result of statistical comparisons of both groups results.

Discussion: It has been determined that the size and preservation of the integrity of talar osteochondral lesions are important factors on clinical results. Results of arthroscopic debridement, microfracture and drilization are not good in lesions larger than 1.5 cm² and lesions with impaired integrity. In our study, depending on the general literature, osteochondral lesions in talus were less than 1.5 cm² in patients who underwent arthroscopic micro fracture and retrograde drilling.

Conclusions: Both microfracture and retrograde subchondral drilling are effective treatment methods with good clinical results for talar osteochondral lesions less than 1,5cm². Retrograde subchondral drilling can be an alternative treatment method with the reliability of clinical results in patients with no loss of the integrity of the cartilage layer or cartilage layer is partially preserved.

Keywords: talus, osteochondral lesion, microfracture, subchondral drilling.

Received: April 28, 2024; Revised: April 28, 2024; Accepted: July 13, 2024; Published: September 13, 2024  Show citation