Comparison of arthroscopic debridement and microfracture in the treatment of osteochondral lesion of talus

Abstract

ObjectiveThis study was performed to compare the clinical effect of arthroscopic debridement vs. arthroscopic microfracture in the treatment of osteochondral lesions of the talus.MethodsWe retrospectively reviewed patients with osteochondral lesion of talus who were admitted to our hospital from April 2020 to April 2021. The patients were divided into Group A (arthroscopic debridement group, n = 39) and Group B (arthroscopic microfracture group, n = 42), and the intraoperative details in the two groups were analyzed. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were compared between the two groups before surgery and at the last follow-up.ResultsThe postoperative AOFAS score (Group A, 40.9–82.26; Group B, 38.12–87.38), VAS score (Group A, 6.44–3.92; Group B, 6.38–2.05) significantly improved in both groups, but the improvement was significantly greater in Group B than in Group A (P < 0.05). Among all patients, the AOFAS and VAS scores of men aged ≤30 years and patients with a low body mass index (BMI) improved more significantly (P < 0.05).ConclusionThe arthroscopic microfracture for the treatment of osteochondral lesion of talus is superior to joint debridement in terms of improving ankle function, especially in relatively young men with a relatively low BMI.

Comparison of Arthroscopic Microfracture for Osteochondral Lesions of the Talus With and Without Small and Shallow Subchondral Cysts

“…However, effective microfracture is usually based on thorough debridement. Zhang et al 33 mentioned in their article that they performed debridement inside of the subchondral cysts before doing microfracture. However, in Lee et al’s 20 study, the average depth of the subchondral cysts was 8 mm, with a maximum depth of 13.7 mm.…”

“…There is also confusion about how to perform microfracture in OLTs with subchondral cysts. Zhang et al 33 made a comparison between pure arthroscopic debridement and microfracture, and found that microfracture could improve clinical outcomes. However, effective microfracture is usually based on thorough debridement.…”

Arthroscopic debridement and microfracture for bilateral osteochondral lesions on the lateral process of the talus involving the subtalar joint: A case report

“…Arthroscopic treatment, including debridement and microfracture, has been reported for OLTs. [17,18,37] Jurina et al [18] reported the clinical outcomes of arthroscopic microfractures for OLTs in skeletally immature patients. In this study, 76.9% of patients were evaluated as having good clinical results according to the Berndt and Harty outcome question.…”

Current Concepts in Clinical Treatment of Osteochondral Lesions of the Talus

“…Establishing criteria for the composition and use of biologics is critical to validate their ability to improve surgical outcomes in BMS [13]. With the innovation of materials and instruments, the effectiveness of other cartilage repair procedures such as fixation and AD has been recognized, and recent studies have reported their surgical efficacy, which might be in conflict with previous studies [16].…”

“…Arthroscopic debridement(AD) is simple and effective method, but conflicting results were reported in a recent study. Zhang et al suggested that microfracture was better than AD in protecting ankle function, while Fermí n et al concluded same efficacy of AD and microfracture, and even a better subchondral bone integrity after AD [15,16].…”