Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the Talus
Background: Osteochondral lesions (OCL) of the talus are a significant cause of chronic ankle pain and functional impairment, typically following trauma. Despite advancements in diagnostic imaging and surgical interventions, long-term outcomes vary, and no gold standard treatment has been establishe...
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| Format: | Article |
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SAGE Publishing
2025-04-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114251329378 |
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| author | Christoph Biehl PD Carina Fritzsche Nike Walter PD Lotta Biehl Thaqif El Khassawna Christian Heiss Markus Rupp MD |
| author_facet | Christoph Biehl PD Carina Fritzsche Nike Walter PD Lotta Biehl Thaqif El Khassawna Christian Heiss Markus Rupp MD |
| author_sort | Christoph Biehl PD |
| collection | DOAJ |
| description | Background: Osteochondral lesions (OCL) of the talus are a significant cause of chronic ankle pain and functional impairment, typically following trauma. Despite advancements in diagnostic imaging and surgical interventions, long-term outcomes vary, and no gold standard treatment has been established. Methods: This retrospective study evaluated the outcomes of n=64 patients undergoing OCL-related surgery. Inclusion criteria: an OCL of the talus, patients without OCL, with osteoarthritis, or infection were excluded. The cohort was categorized primarily based on the stage of OCL and the surgical technique used: bone marrow stimulation by retrograde or anterograde drilling and microfracturing, transplantation of autologous cancellous bone, and acellular cartilage replacement and other procedures. Postoperative outcomes were assessed using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS). Statistical significance was determined using χ 2 tests, with P <.05 considered significant. Results: A total of 97 operations were performed on 64 patients. Fifty-six percent of patients reported complete resolution of symptoms, 25% experienced partial improvement, and 19% showed no improvement. Patients aged ≤30 years had a higher success rate (62.5%) compared with older patients (45.8%, P = .227). Success rates were significantly better for patients with stage II and III lesions (50% and 59%, respectively) than for those with stage IV lesions ( P = .043). Material substitution had a success rate of 44.4%, bone marrow stimulation 37.8%, and other procedures 18.8%. Conclusion: Surgical techniques for treating OCL of the talus provide moderate success, but a significant proportion of patients, especially those with advanced lesions, remain symptomatic. Level of Evidence: Level IV, retrospective case series study. |
| format | Article |
| id | doaj-art-a2488a30a08f45ba91f2a6d672146b21 |
| institution | DOAJ |
| issn | 2473-0114 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj-art-a2488a30a08f45ba91f2a6d672146b212025-08-20T02:58:37ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142025-04-011010.1177/24730114251329378Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the TalusChristoph Biehl PD0Carina Fritzsche1Nike Walter PD2Lotta Biehl3Thaqif El Khassawna4Christian Heiss5Markus Rupp MD6Experimental Trauma Surgery, Justus-Liebig-University of Giessen, Giessen, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, Giessen, GermanyClinic and Polyclinic of Surgery, University Hospital Regensburg Clinic and Polyclinic for Surgery, Regensburg, GermanyMedical Faculty Heidelberg of Heidelberg University, Heidelberg, GermanyExperimental Trauma Surgery, Justus-Liebig-University of Giessen, Giessen, GermanyExperimental Trauma Surgery, Justus-Liebig-University of Giessen, Giessen, GermanyExperimental Trauma Surgery, Justus-Liebig-University of Giessen, Giessen, GermanyBackground: Osteochondral lesions (OCL) of the talus are a significant cause of chronic ankle pain and functional impairment, typically following trauma. Despite advancements in diagnostic imaging and surgical interventions, long-term outcomes vary, and no gold standard treatment has been established. Methods: This retrospective study evaluated the outcomes of n=64 patients undergoing OCL-related surgery. Inclusion criteria: an OCL of the talus, patients without OCL, with osteoarthritis, or infection were excluded. The cohort was categorized primarily based on the stage of OCL and the surgical technique used: bone marrow stimulation by retrograde or anterograde drilling and microfracturing, transplantation of autologous cancellous bone, and acellular cartilage replacement and other procedures. Postoperative outcomes were assessed using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS). Statistical significance was determined using χ 2 tests, with P <.05 considered significant. Results: A total of 97 operations were performed on 64 patients. Fifty-six percent of patients reported complete resolution of symptoms, 25% experienced partial improvement, and 19% showed no improvement. Patients aged ≤30 years had a higher success rate (62.5%) compared with older patients (45.8%, P = .227). Success rates were significantly better for patients with stage II and III lesions (50% and 59%, respectively) than for those with stage IV lesions ( P = .043). Material substitution had a success rate of 44.4%, bone marrow stimulation 37.8%, and other procedures 18.8%. Conclusion: Surgical techniques for treating OCL of the talus provide moderate success, but a significant proportion of patients, especially those with advanced lesions, remain symptomatic. Level of Evidence: Level IV, retrospective case series study.https://doi.org/10.1177/24730114251329378 |
| spellingShingle | Christoph Biehl PD Carina Fritzsche Nike Walter PD Lotta Biehl Thaqif El Khassawna Christian Heiss Markus Rupp MD Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the Talus Foot & Ankle Orthopaedics |
| title | Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the Talus |
| title_full | Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the Talus |
| title_fullStr | Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the Talus |
| title_full_unstemmed | Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the Talus |
| title_short | Midterm Outcomes and Surgical Approaches for Osteochondral Lesions of the Talus |
| title_sort | midterm outcomes and surgical approaches for osteochondral lesions of the talus |
| url | https://doi.org/10.1177/24730114251329378 |
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