Lift, Drill, Fill and Fix (LDFF): a New Arthroscopic Treatment for Talar Osteochondral Defects

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2014 May 21

PMID 24841940

Citations 20

Authors

G M M J Kerkhoffs

M L Reilingh

R M Gerards

P A J de Leeuw

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to describe the short-term clinical outcome of a new arthroscopic fixation technique for primary osteochondral talar defects: lift, drill, fill and fix (LDFF).

Methods: Seven patients underwent an arthroscopic LDFF surgery for osteochondral talar defects, the mean follow-up was 12 months (SD 0.6). Pre- and postoperative clinical assessment included the American Orthopaedic Foot and Ankle Society Score (AOFAS) and the numeric rating scales (NRS) of pain at rest and during walking. Remodelling and bone ingrowth after LDFF were analysed on weight-bearing radiographs during follow-up.

Results: In all patients, LDFF led to an improvement of the AOFAS and NRS of pain. The AOFAS significantly improved from 63 to 99 (p < 0.001). The NRS of pain at rest significantly improved from 2.9 to 0.1 (p = 0.004), and pain with walking significantly improved from 7.6 to 0.1 (p < 0.001). On the final radiographs, five of seven patients showed remodelling and bone ingrowth after LDFF.

Conclusions: The LDFF of an osteochondral talar defect appears to be a promising arthroscopic treatment option for primary talar osteochondral defects. Although the clinical and radiological results of 1-year follow-up are encouraging, more patients and longer follow-up are needed to draw any firm conclusions and determine whether the results stand the test of time.

Level Of Evidence: Prospective case series. Therapeutic, Level IV.

Citing Articles

An Evidence-Based Update on Fixation Procedures for Acute and Chronic Osteochondral Lesions of the Talus.

Nakasa T, Ikuta Y, Haraguchi N, Park C, Weber C, Rikken Q Cartilage. 2024; :19476035241280072.

PMID: 39311645 PMC: 11556605. DOI: 10.1177/19476035241280072.

Operative management of osteochondral lesions of the talus: 2024 recommendations of the working group 'clinical tissue regeneration' of the German Society of Orthopedics and Traumatology (DGOU).

Walther M, Gottschalk O, Aurich M EFORT Open Rev. 2024; 9(3):217-234.

PMID: 38457916 PMC: 10958247. DOI: 10.1530/EOR-23-0075.

Open lift-drill-fill-fix for medial osteochondral lesions of the talus: surgical technique.

Rikken Q, Favier B, Dahmen J, Stufkens S, Kerkhoffs G Oper Orthop Traumatol. 2023; 36(2):132-144.

PMID: 37828133 PMC: 11014820. DOI: 10.1007/s00064-023-00833-7.

The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions.

Hollander J, Dahmen J, Emanuel K, Stufkens S, Kennedy J, Kerkhoffs G Cartilage. 2023; 14(2):180-197.

PMID: 37144397 PMC: 10416205. DOI: 10.1177/19476035231154746.

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for lateral osteochondral lesions of the talus: operative technique.

Dahmen J, Rikken Q, Kerkhoffs G, Stufkens S Oper Orthop Traumatol. 2023; 35(2):82-91.

PMID: 36622413 PMC: 10076387. DOI: 10.1007/s00064-022-00789-0.

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