Clinical effects of arthroscopic microfracture on osteochondral lesions of the talus / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of arthroscopic microfracture on osteochondral lesions of the talus.</p><p><b>METHODS</b>Total 42 patients with osteochondral lesions of the talus, who were collected in our department from January 2011 to December 2013. The patients were 35.9 years old on average, including 28 males and 14 females. There were 34 patients who had injury histories. The debridement and microfracture were performed under arthroscopy. The function of ankle was assessed according to AOFAS Ankle Hindfoot Scale. MRI of ankle was checked 2 years postoperatively.</p><p><b>RESULTS</b>There were 23 cases in stage 3, 9 cases in stage 4 and 10 cases in stage 5 in MRI. There were 25 cases on the 4th district, 11 cases on the 6th district, 4 cases on the 1st district, 2 cases on the 3rd district according to 9 districts location and 8 cases of subchondral cyst found on the 4th district. AOFAS Ankle Hindfoot Scale of all patients on the 1st year postoperatively was 73.3±3.9 which was significantly better than 50.4±7.8 preoperatively, and 81.1±4.8 on the 2nd year postoperatively was also significantly better than that on the 1st year postoperatively.</p><p><b>CONCLUSIONS</b>Arthroscopic microfracture for the osteochondral lesions of the talus could have a good clinical effect.</p>

Autologous Chondrocyte Implantation as a Secondary Procedure after Failed Microfracture for Osteochondral Lesion of Talus / 대한족부족관절학회지

Microfracture as a reparative strategy is the treatment of choice for an osteochondral lesion of talus. Although the results of microfracture are generally excellent, at least 30% of patients who received microfracture have acute or chronic ankle pain with several or unknown causes. The most important factor for unsatisfactory outcome after microfracture is the size of the lesion. For failed osteochondral lesion of talus, the second options are autologous osteochondral graft, autologous chondrocyte implantation, or re-microfracture. In this article, we present the autologous chondrocyte implantation as a second procedure for failed microfracture and compare its clinical outcome with other methods based on a literature review.

Redomicrofracture as a Treatment for Osteochondral Lesion of Talus after the Failure of Arthroscopic Microfracture / 대한족부족관절학회지

Arthroscopic treatment has been reported to provide effective improvement of ankle function when used in treatment of small osteochondral lesion of talus; however, favorable long-term results have been less predictable for large osteochondral lesion of talus. In cases in which primary arthroscopic treatment fails, the decision regarding which subsequent technique to choose has become increasingly difficult, as good clinical outcomes may be unlikely for such patients irrespective of the surgical technique used. Redomicrofracture should be used judiciously for treatment of osteochondral lesion of talus in which arthroscopic treatment has failed.

Autologous Osteochondral Transplantation as a Secondary Procedure after Failed Microfracture for Osteochondral Lesion of Talus / 대한족부족관절학회지

Microfracture procedure has been widely recognized as the primary surgical treatment for an osteochondral lesion of the talus. However, if symptoms persist after initial surgery, selection of a secondary procedure can be difficult. The author desciribes the advantage and value of autologous osteochondral transplantation as a secondary procedure after failed microfracture for osteochondral lesion with a review of sevral previous published articles.