Use of microfracture for osteochondral lesions of the talus in the National Basketball Association (NBA) is controversial.
NBA players would be able to return to pre-injury playing status by arthroscopic debridement alone without marrow stimulation techniques.
To determine results of arthroscopic debridement of osteochondral lesions of the talus on performance and career longevity for National Basketball Association (NBA) players.
Between the 2000-2015 seasons, 10 NBA players were treated with arthroscopic debridement of an osteochondral lesion of the talus. Preoperative and postoperative outcomes including seasons played, games played, games started, minutes per game, points per game, field goals, 3-point shots, rebounds, assists, double doubles, triple doubles, steals, blocks, turnovers, personal fouls, assists per turnovers, steals per turnovers, NBA rating, scoring efficiency, and shooting efficiency were compared. In addition, these NBA players were compared to a match controlled group using mixed effects regression and Fisher’s least significance difference modeling.
Ten of the ten players (100%) returned to play in the NBA following arthroscopic debridement without microfracture or drilling of an osteochondral lesion of the talus. When compared to preoperative performance, postoperative mean points scored, assists made, and steals made increased by 2.86 (P=.042), 0.61 (P=.049), and 0.15 (P=.027) respectively. Only field goal percentage decreased postoperatively when compared to matched controls; however, this normalized by the end of the 2nd season after surgery. There was no statistically significant change in any of the other performance factors when compared to matched controls. All patients returned to basketball either during the same season (1) or the following season (9) if the operation was performed during the off-season. The average length of career after surgery was 4.1 years with five players currently still playing in the league.
Following arthroscopic debridement of an osteochondral lesion of the talus without drilling or microfracture, there is a high rate of return to sport in the NBA with improved points scored, assists and steals made after surgery when compared to preoperative performance. Furthermore, there is no statistically significant change in any performance factors when compared to healthy, uninjured matched controls. The size of the lesion did not affect the length of the players’ career. This data should be used to manage patients’ and team expectations regarding their abilities to return to elite levels of athletic performance following surgery of an OLT.