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Arthroscopic treatment of osteochondral lesions of the talus

Avon Orthopaedic Centre, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.

A. J. Kelly, FRCS Orth, Consultant Orthopaedic Surgeon

Taunton and Somerset Hospital, Musgrove Park, Taunton, Somerset TA1 5DA, UK.

Correspondence should be sent to Mr D. E. Robinson at Flat 2, Alma House, 25 Alma Road, Clifton, Bristol BS8 2BZ, UK.

We reviewed, retrospectively, 65 patients who had undergone arthroscopic treatment for osteochondral lesions of the talus. The 46 men and 19 women with a mean age at operation of 34.25 years, were followed up for a mean of 3.5 years. The medial aspect was affected in 45 patients and the lateral aspect in 20. All the lateral lesions and 35 (75%) of the medial lesions were traumatic in origin. Medial lesions presented later than lateral lesions (3 v 1.5 years) and had a much greater incidence of cystic change (46% v 8%).

At follow-up, 34 patients had achieved a good result, and 17 and 14 fair and poor results, respectively. Of the 14 poor results, 13 involved medial lesions. Cystic lesions had a poor outcome in 53% of patients. Excision and curettage led to better results than excision and drilling of the base. Further arthroscopic surgery for patients with a poor result was disappointing. There was no association between outcome and the patient’s age.

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