Operative treatment of osteochondral lesions of the talus in children

Abstract

Literature on the operative treatment of osteochondral lesion of the talus in children is scarce. The aim of this study was to evaluate the mid-term clinical outcomes of arthroscopic bone marrow stimulation with microfracturing for the treatment of osteochondral lesion of the talus in skeletally immature children. Thirteen patients with osteochondral lesion of the talus, treated by arthroscopic bone marrow stimulation with microfracturing before skeletal maturity, were included in the study. At the evaluation visit, patient subjective satisfaction with the operation was assessed using the Berndt and Harty questionnaire, Single Assessment Numeric Evaluation questionnaire and Martin questionnaire. Functional outcome was evaluated by using the American Orthopedic Foot and Ankle Society score. Short Form 36 questionnaire was used to assess the health related quality of life. The median patient age at the time of operation was 15 (range 13-16) years. The median time elapsed between the operation and evaluation was 5.6 (range 3.8-13.6) years. According to the Berndt and Harty questionnaire, ten patients reported good results and three patients fair results. Eleven patients had excellent or good results according to the Single Assessment Numeric Evaluation questionnaire. There was signifi cant improvement in the postoperative American Orthopedic Foot and Ankle Society score as compared with the preoperative American Orthopedic Foot and Ankle Society score, with a mean increase of 35 points. The median Short Form 36 questionnaire physical and mental common scores were within the normal range for the Croatian population. In conclusion, arthroscopic bone marrow stimulation with microfracturing is a safe and eff ective method in the treatment of osteochondral lesion of the talus in skeletally immature children.