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Fixation of the osteochondral talar fragment yields good results regardless of lesion size or chronicity

  • Naoki HaraguchiEmail author
  • Takaki Shiratsuchi
  • Koki Ota
  • Takuma Ozeki
  • Masaki Gibu
  • Hisateru Niki
Ankle
  • 47 Downloads

Abstract

Purpose

Osteochondral talar lesions, regardless of their size and/or chronicity, are, at our hospital, now treated by fixation of the fragment if the talar dome cartilage is judged to be healthy. The retrospective study described herein was conducted to assess clinical outcomes of this treatment strategy.

Methods

The study group comprised 44 patients (18 men and 26 women) with 45 such talar lesions. In all cases, the osteochondral fragment was reduced and fixed with bone harvested from the osteotomy site and shaped into peg(s) (one to four pegs per lesion). Median follow-up was 2.1 years (1–9 years). The lesion area was measured on computed tomography arthrographs, and the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale was used to evaluate postoperative outcomes. Clinical failure was defined as a JSSF score < 80 points.

Results

The mean JSSF score improved significantly from 63.5 points preoperatively to 93.0 postoperatively (p < 0.001). Treatment failure occurred in only one ankle (0.02%). The mean lesion area was 51.2 mm2 (range 5–147 mm2). Correlation between lesion areas and the postoperative JSSF scores was weak (r = − 0.133). Correlation between the time of the trauma to the time of fixation surgery and the postoperative JSSF scores was also weak (r = 0.042). Radiographic outcomes were good for 28 ankles, fair for 10, and poor for 7.

Conclusion

Fixation of the lesion fragment, regardless of size and/or chronicity, appears to be appropriate in cases of an osteochondral talar lesion.

Level of evidence

IV.

Keywords

Ankle Osteochondral talar lesion Fixation of osteochondral fragment Bone peg 

Notes

Funding

No external source of funding was used.

Compliance with ethical standards

Conflict of interest

Naoki Haraguchi, Takaki Shiratsuchi, Koki Ota, Takuma Ozeki, Masaki Gibu, and Hisateru Niki declare that they have no conflict of interest.

Ethical approval

This study was approved by the review board of our hospital. All procedures performed were in accordance with the ethical standards of the institutional research committee (Institutional Review Board of Tokyo Metropolitan Police Hospital, Approval no. 19-A02) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgerySt. Marianna University Yokohama Seibu HospitalYokohamaJapan
  2. 2.Department of Orthopaedic SurgeryTokyo Metropolitan Police HospitalTokyoJapan
  3. 3.Department of Orthopaedic SurgerySt. Marianna University School of MedicineKawasakiJapan

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