A prospective,single-center study following operative treatment for osteochondral lesions of the talus |
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| Affiliation: | 1. Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Zalo?ka cesta 9, 1000 Ljubljana, Slovenia;2. Chair of Orthopaedics, Faculty of Medicine, University of Ljubljana, Kongresni trg 12, 1000 Ljubljana, Slovenia;3. Sanatorij MD Medicina, Bohori?eva ulica 5, 1000 Ljubljana, Slovenia;1. Department of Physical Medicine and Rehabilitation, Liege University Hospital Center, University of Liège, Liège, Belgium;2. Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium;3. UCLouvain, Faculty of Motor Sciences at Université Catholique de Louvain-La-Neuve, Louvain, Belgium;4. HEL (Haute Ecole de la ville de Liège), Liège, Belgium;5. Department of Physical Medicine and Sports Traumatology, SportS(2), FIFA Medical Centre of Excellence, University and University Hospital of Liège, Liège, Belgium;1. Centre Ostéo-articulaire des Cèdres-Echirolles, France;2. Service de Chirurgie Orthopédique et Traumatologique, CH Métropole Savoie, Chambéry, France;3. Clinique du Mail-Grenoble, France;4. Alexandra Hospital, Harlow, United Kingdom;5. Sports Surgery Clinic, Santry, Dublin 9, Ireland;1. Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Department of Orthopedics and Traumatology, Istanbul, Turkey;2. Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey;3. Kars Harakani State Hospital, Department of Orthopedics and Traumatology, Kars, Turkey;1. University of Washington School of Medicine, United States;2. DVA Puget Sound Health Care System, United States;3. Department of Orthopaedics and Sports Medicine, University of Washington, United States |
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| Abstract: | Background(1) To evaluate patient-reported outcomes and revision surgeries after various operative interventions for osteochondral lesions of the talus (OLT) in a prospective single center series over 10 years, and (2) to identify predicting factors related to subjective ankle status and quality of life pre- and postoperatively.MethodsNinety-nine patients underwent operative treatment due to primary or recurrent OLT, with an average follow up 3.5 (1.8) years. Treatment outcome was followed clinically (FAOS, EQ-5D, Tegner activity scale) and by pursuing any serious adverse events or graft failures.ResultsThere were 80 responding patients (81%) for the study. The mean lesion size was 2.0 (1.1) cm2. All FAOS values increased from preoperative to final follow-up values (Symptoms 60–68, Pain 58–69, ADL 71–80, Sport 36–54, QoL 30–45). EQ-5D increased from 0.49 to 0.62, while Tegner activity scale change from 3.2 to 3.4. There were 19 (24%) serious adverse events recorded; 13 (16%) of them were graft-related. Graft survival rates were 100% at 1 year, 94% (males)/93% (females) at 2 years, and 77% (males)/47% (females) at 5 years. Female gender, higher BMI, and higher Kellgren-Lawrence ankle OA score were negative predictors for preoperative patient-reported ankle joint status. The foremost improvement after operative intervention was observed in patients with large osteochondral lesions without postoperative adverse events.ConclusionVarious operative interventions for OLT significantly improved patients’ ankle status and quality of life. High graft survival rates were demonstrated over first two years, but notable decline was confirmed thereafter, especially in female patients. |
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| Keywords: | Ankle Talus Osteochondral Lesion Debridement Microfractures Mesenchymal stem/stromal cells Osteochondral scaffold Quality of life Activity level Pain Graft failure |
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