Arthroscopic microfracture for osteochondral lesions of the talus

The purpose of the present study was to evaluate the outcomes of arthroscopic microfracture for isolated osteochondral lesions of the talus without combined lesions, in patients of less than 50 years old with lesions of <1.5 cm². Thirty-five patients (35 ankles) with isolated osteochondral lesions of the talus were treated by arthroscopic microfracture. There were 27 men and 8 women of average age 35 years (range 17–50) and mean body mass index (BMI) 25 kg/m² (range 20–34) at the time of surgery. Clinical outcome evaluations were performed at a mean follow-up of 33 months. Overall results, as determined using American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, were excellent in 16 (46%), good in 15 (43%), and fair in 4 (11%). Mean AOFAS scores improved from 63 points (range 52–77) preoperatively to 90 points (range 73–100) at final follow-up, median Ankle Activity Score (AAS) from 3 points (range 1–5) to 6 points (range 3–8), mean Visual Analogue Scale (VAS) scores from 7 points (range 5–8) to 2 points (range 0–5), and mean Short Form-36 scores showed improvements in physical function, role limitation, bodily pain, social function, and general health (P < 0.05). In terms of prognostic factors, a longer symptom duration was found to negatively affect outcome, as determined by AOFAS scores, AAS, and VAS scores. Arthroscopic microfracture for isolated osteochondral lesions of the talus is a safe and effective procedure, which provides good clinical outcomes in the majority of patients.