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Posterior arthroscopic treatment of ankle osteochondral lesions: technical note
  1. Jorge Pablo Batista1,2,
  2. Hélder Miguel Duarte Pereira3,
  3. C. Niek van Dijk4,
  4. Jorge Javier Del Vecchio5
  1. 1 Arthroscopy, Centro Artroscopico Jorge Batista SA, Buenos Aires, Argentina
  2. 2 Professional Soccer, Club Atletico Boca Juniors, Buenos Aires, Argentina
  3. 3 University of Minho, Braga, Portugal
  4. 4 Amsterdam University Medical Centres, Amsterdam, The Netherlands
  5. 5 Fundación Favaloro Hospital Universitario, Buenos Aires, Argentina
  1. Correspondence to Dr Jorge Javier Del Vecchio, Fundación Favaloro Hospital Universitario, Buenos Aires 1078, Argentina; javierdv{at}mac.com

Abstract

Osteochondral lesions of the ankle are lesions that involve the cartilage and the subchondral bone of the talus. The aim of this study is to describe the clinical results of a consecutive case series of posterior osteochondral lesions of the talus treated with debridement and bone marrow stimulation by means of posterior ankle arthroscopy. We hypothesise that posterior ankle arthroscopy is an effective and safe procedure to treat lesions less than 10–15 mm in size and 5 mm in depth located in zones 7, 8 and 9 of the Raikin and Elias grid. We prospectively analysed the outcomes of 36 patients who underwent posterior endoscopic treatment of osteochondral lesions of the talus. The American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating system and the Foot and Ankle Ability Measure were used and patient satisfaction was evaluated. Visual Analogue Scale (VAS) was complementarily used with these measures to evaluate the clinical behaviour of the patients. The average AOFAS score improved from 42.3 preoperatively to 89.29 postoperatively. All patients were satisfied with the surgical outcome and would choose this surgical treatment again. Three minor and transitory postoperative complications (5.55%) were observed: one patient with pain on the portals, one ecchymosis and one hypoesthesia of the heel. The average score on VAS improved from 7.75 preoperatively to 1.54 postoperatively, with an average improvement of 6.21 points. 75% of patients were able to resume their ‘preinjury’ physical activity level. The posterior arthroscopic approach with bone marrow stimulation is technically simple and is a safe and effective procedure to treat posterior talar osteochondral lesions. It has few complications, thus reducing time to return to sports and/or work activity.

Level of evidence IV, case series.

  • ankle
  • endoscopy
  • cartilage
  • outcome studies
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Footnotes

  • Contributors JPB: planning, conduct and reporting of the study. JJDV: reporting of the study. HMDP: conduct of the study. NvD: planning and reporting of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical clearance was obtained from the CAJB Human Resource Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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