2015 ISAKOS Biennial Congress ePoster #119

Posterior Endoscopic Approach in Osteochondral Lesions of the Talus

Jorge Pablo Batista, MD, San Isidro, Buenos Aires ARGENTINA
Sebastian Osorio Fernandez, MD, Buenos Aires ARGENTINA
Rodrigo Maestu, MD, Boulogne, Buenos Aires ARGENTINA
Luciano Patthauer, MD, Buenos Aires ARGENTINA
Martin Luciano Pagliarone, MD, Buenos Aires ARGENTINA
Club Atlético Boca Juniors- Centro Artroscópico Jorge Batista SA, Ciudad Autónoma de Buenos Aires (CABA), Buenos Aires, ARGENTINA

FDA Status Not Applicable

Summary: The posterior endoscopic approach is a safe and effective therapeutic alternative for the treatment of the talar osteochondral lesions

Abstract:

Introduction

Osteochondral ankle injuries are relatively rare lesions that primarily involve the cartilage and subchondral bone of the talus, and are presented with a variable incidence ranging et al, 0.09 to 4% according to different authors. The aim of this research is to present the clinical results of a case series treated consecutively by a subsequent ankle arthroscopy for the treatment of osteochondral lesions of the talus (Zones 7,8,9 of Raikin).

Material And Method

We analyzed prospectively the performance of 24 patients who underwent posterior arthroscopic treatment of osteochondral lesions of the talus. The average follow-up of 26.2 months (R= 18-84). The Ankle and Hindfoot AOFAS score was used and 4 questions at the time of the evaluation were made:
1- Satisfaction with surgical outcome
2- Whether they would be subject to the intervention again
3- If pain in the portals were present
4- If they had resumed their prior physical activity level.
And short form health survey-36 scores (SF-36) was conducted to evaluate quality of life.

Results

The post operative AOFAS score was 85,29 points (R= 60 to 100). All patients were satisfied with the surgery outcome and would be subject to the intervention again. As a overall result the patients had a significant improvement of their SF-36 physical component. Complications that was observed: Two patients (8,33%) had immediate mild post-operative complications: 1 equimosis and 1 transitory hypoesthesia of the heel. The 50% of the patients presented induration and pain in the portals within 2 months after the surgery. The 25% was unable to resume their prior physical activity level.

Conclusions

The posterior arthroscopic approach is a safe and effective therapeutic alternative for the treatment of these injuries. Resection of the fragment by arthroscopic approach is technically simple, reproducible, safe, with few complications and clinical relevance, thus reducing the time of return to sport and / or work activity in relation to open procedures.