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Osteochondral lesions of the talus: are there any differences between osteochondral and chondral types?

Title
 Osteochondral lesions of the talus: are there any differences between osteochondral and chondral types?
Authors
 Gi Won Choi; Woo Jin Choi; Jin Woo Lee; Yoo Jung Park; Hyun Kook Youn
Issue Date
2013
Journal Title
 American Journal of Sports Medicine
ISSN
 0363-5465
Citation
 American Journal of Sports Medicine, Vol.41(3) : 504~510, 2013
Abstract
BACKGROUND: Among the types of osteochondral lesions of the talus (OLTs), the osteochondral and chondral types make up the majority of OLTs. There is a possibility that between these two types of lesions, the clinical outcomes and characteristics may differ. PURPOSE: This study was designed to compare the clinical outcomes, demographics, and characteristics of osteochondral- and chondral-type lesions of OLTs. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The authors retrospectively analyzed 298 ankles that underwent arthroscopic marrow-stimulating procedures for OLTs between 2001 and 2009 that had been arthroscopically determined as either chondral type (210 ankles) or osteochondral type (88 ankles). Clinical outcomes, demographics, and characteristics of the lesions were compared. RESULTS: The age distribution showed that the chondral type reached its peak in patients in their 50s, whereas the osteochondral type had a peak distribution for those in their 20s. The average duration of symptoms was greater in the chondral type (28.3 months; range, 7-240 months) than in the osteochondral type (14.4 months; range, 8-120 months) (P < .001). With regard to the characteristics of the lesions, differences only existed in the combined intra-articular lesions between the two types. Subchondral cysts (odds ratio [OR], 3.71; 95% CI, 1.61-8.55; P = .001) and soft tissue impingement (OR, 1.82; 95% CI, 1.10-3.03; P = .021) were more frequently present in the chondral type. The American Orthopaedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) for pain showed significant improvement from preoperative to postoperative scores in both groups. However, the preoperative and postoperative VAS and AOFAS scores did not differ significantly between the groups. CONCLUSION: Differences were found with age distribution, duration of symptoms, and combined intra-articular lesions between the osteochondral- and chondral-type lesions of OLTs. We achieved similar successful clinical outcomes in both types of lesions using arthroscopic marrow stimulating procedures, such as microfracture or abrasion arthroplasty.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/86586
DOI
10.1177/0363546512472976
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Orthopedic Surgery
Yonsei Authors
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Link
 http://ajs.sagepub.com/content/41/3/504.long
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