Re-operation Rate After Surgical Treatment of Osteochondral Lesions of the Talus in Paediatric and Adolescent Patients

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2021 Mar 16

PMID 33722244

Citations 5

Authors

Daniel Korner

Christoph E Gonser

Stefan Dobele

Christian Konrads

Fabian Springer

Gabriel Keller

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents.

Methods: Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus. 'Re-operation' as the outcome measure was evaluated after a median follow-up of 42 months (range 6-117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables.

Results: Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13-61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001).

Conclusions: We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.

Citing Articles

Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus.

Liu L, Jin J, Pan J, Guo H, Li S, Li J J Orthop Traumatol. 2025; 26(1):8.

PMID: 39918724 PMC: 11806161. DOI: 10.1186/s10195-025-00818-1.

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.

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A Systematic Review of the Retrograde Drilling Approach for Osteochondral Lesion of the Talus: Questioning Surgical Approaches, Outcome Evaluation and Gender-Related Differences.

Veronesi F, Maglio M, Brogini S, Mazzotti A, Artioli E, Giavaresi G J Clin Med. 2023; 12(13).

PMID: 37445558 PMC: 10342543. DOI: 10.3390/jcm12134523.

Juvenile Osteochondral Lesions of the Talus: Current Concepts Review and an Update on the Literature.

Anastasio A, Bagheri K, Peairs E, Grant C, Adams S Children (Basel). 2023; 10(5).

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Zhang G, Chen N, Ji L, Sun C, Ding S J Orthop Surg Res. 2023; 18(1):118.

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