scholarly journals Return to Play after Arthroscopic Microfracture for Osteochondral Lesions of the Talus in Young Elite Athletes

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0029
Author(s):  
Sung-Jae Kim ◽  
Kyung-tai Lee
Keyword(s):  
Elite Athletes ◽  
Return To Play ◽  
Rate Of Return ◽  
Osteochondral Lesions ◽  
Return To Sports ◽  
Sports Activity ◽  
Vas Score ◽  
Arthroscopic Microfracture ◽  
The Mean

Category: Ankle; Arthroscopy Introduction/Purpose: The current scientific evidence for the clinical and sports-related outcomes of the surgical treatment of osteochondral lesions of the talus (OLTs) with arthroscopic microfracture (MF) in elite athletes is scarce. The purpose of curretn study is to evaluate the clinical outcomes and return to sports activity after arthroscopic MF for OLTs in elite athletes. Methods: The files of 41 elite athletes (mean age 19.34 +- 3.76 years) who had undergone arthroscopic MF for OLTs at our institution between January 2011 and September 2015 were retrospectively reviewed. The Foot and Ankle Outcome Score (FAOS), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot and visual analog pain (VAS) score, time and rate of ‘return-to-competition’ (RTC, defined as return to an official match for at least one minute after treatment), and rate of ‘return- to-play’ (RTP, defined as participation in at least two entire seasons after treatment) were used to evaluate the outcomes. We compared athletes who were able to RTP (RTP-group) with those who were not (No-RTP group). Results: The mean follow-up was 54.9 +- 13.72 months. All five subscales of preoperative FAOS were significantly improved at the final follow-up. The mean preoperative AOFAS hindfoot score of 74.46 +- 8.10 improved to 91.62 +- 2.99 (P < 0.001) at the final follow-up. The mean preoperative VAS score of 5.44 +- 1.57 improved to 2.66 +- 1.04 (P < 0.001). All patients achieved RTC (100%) at mean time of 5.45 +- 3.18 months, and 74.4% of patients were able to RTP. The RTP-group showed significantly smaller lesions compared to the No-RTP group (71.52 +- 43.29 vs. 107.00 +- 45.28 mm2, P = 0.009). The cut-off OLT size for predicting RTP was 84.0 mm2, with a sensitivity of 90.0% and specificity of 75.9%. Conclusion: All athletes were able to RTC at average of 5.45 months after MF for OLTs, and 74.4% were able to RTP. The only prognostic variable for RTP was lesion size, and its predictive cut-off was 84 mm2.

Clinical Outcomes of Osteochondral Lesions of the Tibial Plafond Following Arthroscopic Microfracture

2019 ◽  
Vol 40 (9) ◽  
pp. 1018-1024
Author(s):  
Wonyong Lee ◽  
Sterling Tran ◽  
Minton T. Cooper ◽  
Joseph S. Park ◽  
Venkat Perumal
Keyword(s):  
Clinical Outcomes ◽  
Osteochondral Lesions ◽  
Return To Sports ◽  
Functional Evaluation ◽  
Sports Activity ◽  
Arthroscopic Microfracture ◽  
Tibial Plafond ◽  
Functional Scores ◽  
The Mean

Background: The purpose of this study was to evaluate the clinical outcomes and the level of sports activity following arthroscopic microfracture for osteochondral lesions of the tibial plafond. Methods: A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. For functional evaluation, the visual analog scale (VAS) pain score, Foot and Ankle Ability Measure (FAAM) score, and Short Form-12 (SF-12) general health questionnaire were used. We also investigated the level of sports activity before and after the surgery. Sixteen patients were included in this study, and the mean follow-up period was 29.8 months. Results: The mean VAS score improved from 8.3 (range, 6-10) preoperatively to 1.8 (range, 0-4) postoperatively. The mean FAAM score was improved from 57.6 (range, 6.0-88.9) for the activities of daily living subscale and 34.5 (range, 3.1-92.6) for the sports subscale to 84.3 (range, 46.4-100.0) and 65.2 (range, 23.3-55.1) for each subscale, respectively, at the final follow-up. There were also improvements in the SF-12 score, from 36.3 (range, 23.3-55.1) preoperatively to 46.0 (range, 18.9-56.6) postoperatively for the SF-12 PCS, and from 41.3 (range, 14.2-65.0) preoperatively to 52.6 (range, 32.8-60.8) postoperatively for the SF-12 MCS. All functional scores showed significant differences clinically and statistically at the final follow-up. The level of sports activity after the surgery was significantly lower than their level before the surgery ( P = .012). Conclusion: Arthroscopic microfracture provided satisfactory clinical outcomes for osteochondral lesions of the tibial plafond. Though all the patients in this study were able to return to sports activity after the surgery, the postoperative level of sports activity was significantly lower than their preoperative level. Level of Evidence: Level IV, retrospective case series.

scholarly journals Clinical Outcomes of Osteochondral Lesions of the Tibial Plafond Following Arthroscopic Microfracture

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0027
Author(s):  
Wonyong Lee ◽  
Joseph S. Park ◽  
Minton T. Cooper ◽  
Venkat Perumal
Keyword(s):  
Clinical Outcomes ◽  
Short Form ◽  
Osteochondral Lesions ◽  
Return To Sports ◽  
Functional Evaluation ◽  
Sports Activity ◽  
Arthroscopic Microfracture ◽  
Tibial Plafond ◽  
The Mean

Category: Ankle, Arthroscopy Introduction/Purpose: There is little data regarding osteochondral lesions of the tibial plafond with only a few studies reporting clinical outcomes after arthroscopic treatment. The purpose of this study is to evaluate the clinical outcomes and the level of sports activities following arthroscopic microfracture for osteochondral lesions of the tibial plafond. Methods: A retrospective review was conducted for all patients who underwent arthroscopic microfracture surgery for ankle osteochondral lesions from January 2014 to June 2017. For functional evaluation, the Visual Analog Scale (VAS) pain score, Foot and Ankle Ability Measure (FAAM) score, and Short Form-12 (SF-12) general health questionnaire were used. We also investigated the level of sports activity before and after the surgery. Results: 16 patients were included in the study, and the mean follow-up period was 29.8 months. The mean FAAM score was significantly improved from 57.6 (range, 6.0-88.9) for the activities of daily living subscale and 34.5 (range, 3.1-92.6) for the sports subscale to 84.3 (range, 46.4-100.0) and 65.2 (range, 23.3-55.1) for each subscale respectively at the final follow-up. There were also significant improvements in SF-12 score, from 36.3 (range, 23.3- 55.1) to 46.0 (range, 18.9-56.6) for SF-12 PCS, and from 41.3 (range, 14.2-65.0) to 52.6 (range, 32.8-60.8) for SF-12 MCS at the final follow-up. Although 16 of 16 (100%) were able to return to their sports activity, the level of sports activity was lower than their level before the surgery. Conclusion: Arthroscopic microfracture provided satisfactory clinical outcomes for osteochondral lesions of the tibial plafond. Though one hundred percentage of patients were able to return to sports activity after the surgery, the level of sports activity was lower than their level before the surgery.

Lesão SLAP Tipo II Isolada em Desportistas – Reparação Labral ou Tenodese da Longa Porção do Bicípite. Análise de Resultados e Taxa de Return to Play

2021 ◽  
Vol 12 (3) ◽  
pp. 27-30
Author(s):  
André Barros ◽  
◽  
Sérgio Gonçalves ◽  
Eduardo Carpinteiro ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Clinical Results ◽  
Return To Play ◽  
Rate Of Return ◽  
Labral Repair ◽  
Return To Sports ◽  
Sports Activity ◽  
Previous Level ◽  
The Mean

Introduction: SLAP injuries are common in young athletes and in the military men. In the failure of conservative treatment, surgical treatment is indicated. Objectives: To compare clinical results in two groups of sportsmen and military men with SLAP type II injuries who underwent two surgical techniques. Material and methods: Retrospective study, in sportsmen and military personnel submitted to surgical treatment between 2010 and 2018. Each group was submitted to the same technique by the same surgical team. Clinical evaluation was performed with a Constant (SC) score, complications were recorded, surgical re-interventions, rate of return to sports activity and rate of return to the previous level of activity. Results: We analyzed 25 patients, 12 who underwent labral repair (RL) and 13 who underwent bicipital tendon tenodesis (TLPB). The mean follow-up was 4.5 years, the mean age was 25.7 years for the RL group and 31 years for the TLPB group. There was an improvement in SC in both groups. In the RL, there were 4 cases of post-operative stiffness with two re-interventions, whereas with the TLPB there was a failure with tenodesis rupture. The rate of return to sports activity was 100% in both groups, but in the RL group the rate of return to the previous level was 42% and in the TLPB group 70%. Conclusions: Both techniques have good clinical results in the medium and long term. In our series, the results are superior for TLPB and without re-interventions. In the RL group, the rate of complications was higher and the rate of return to the previous level of sports activity was lower.

scholarly journals Outcomes and rate of return to play in elite athletes following arthroscopic surgery of the hip

2021 ◽  
Author(s):  
R. Elwood ◽  
O. El-Hakeem ◽  
Y. Singh ◽  
H. Shoman ◽  
O. Weiss ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Elite Athletes ◽  
Arthroscopic Surgery ◽  
Return To Play ◽  
Rate Of Return ◽  
Labral Repair ◽  
Return To Sports ◽  
Post Surgery ◽  
Patient Reported

Abstract Background The tremendous physical demands of elite performance increase the risk of elite athletes sustaining various orthopaedic injuries. Hip pain is common in high-level athletes representing up to 6% of all athletic injuries. Expedient diagnosis and effective treatment are paramount for their future sporting careers and to prevent subsequent joint degeneration. Purpose This systematic review aimed to evaluate the outcome and the rate of return to play (RTP) following arthroscopic procedures in the hip (osteoplasty, chondroplasty, labral repair and/or debridement, capsulotomy, capsulorrhaphy or any soft tissue procedure) in elite athletes. Elite athletes were defined as those who represented their country in international contests or were competing professionally for the purpose of this study. Methods A computer-based systematic search, following the PRISMA Guidelines, was performed on CENTRAL, PUBMED, EMBASE, SCOPUS, EBSCO, Google Scholar and Web of Science from inception until January 1, 2020, identifying studies that looked at return to sports post-hip arthroscopy in elite athletes. Weighted means were calculated for the RTP rate and duration and for patient-reported outcome measures (PROMs). Results After eligibility screening, 22 articles were included with a total of 999 male and seven female patients, 1146 hips and a mean age of 28.4 ± 3.2 years. The mean follow-up period was 35.8 ± 13.4 months and 15.9 ± 9.6% of athletes had undergone bilateral procedures. Overall, 93.9% (95% CI: 90.5, 96.6, P < 0.0001) of patients demonstrated RTP after 6.8 ± 2.1 months post-surgery and all PROMs improved post-operatively. During follow-up, 9.6% (95% CI: 5.2, 15.2, P = 0.025) patients needed further intervention. Conclusion A high percentage of elite athletes return to the same level of competition after hip arthroscopy, with a low rate of further interventions. Hip arthroscopy appears to be an efficacious treatment for hip and/or groin pain, caused by pathologies such as FAI or labral tears, in elite athletes in the shorter term. Long term outcomes need further evaluation.

Criteria for Return to Play After Hip Arthroscopy in the Treatment of Femoroacetabular Impingement: A Systematic Review

2021 ◽  
pp. 036354652110389
Author(s):  
Martin S. Davey ◽  
Eoghan T. Hurley ◽  
Matthew G. Davey ◽  
Jordan W. Fried ◽  
Andrew J. Hughes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Operative Management ◽  
Return To Play ◽  
Return To Sports ◽  
Level Of Evidence ◽  
The Mean

Background: Femoroacetabular impingement (FAI) is a common pathology in athletes that often requires operative management in the form of hip arthroscopy. Purpose: To systematically review the rates and level of return to play (RTP) and the criteria used for RTP after hip arthroscopy for FAI in athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature, based on the PRISMA guidelines, was performed using PubMed, Embase, and Scopus databases. Studies reporting outcomes after the use of hip arthroscopy for FAI were included. Outcomes analyzed were RTP rate, RTP level, and criteria used for RTP. Statistical analysis was performed using SPSS software. Results: Our review found 130 studies, which included 14,069 patients (14,517 hips) and had a mean methodological quality of evidence (MQOE) of 40.4 (range, 5-67). The majority of patients were female (53.7%), the mean patient age was 30.4 years (range, 15-47 years), and the mean follow-up was 29.7 months (range, 6-75 months). A total of 81 studies reported RTP rates, with an overall RTP rate of 85.4% over a mean period of 6.6 months. Additionally, 49 studies reported the rate of RTP at preinjury level as 72.6%. Specific RTP criteria were reported in 97 studies (77.2%), with time being the most commonly reported item, which was reported in 80 studies (69.2%). A total of 45 studies (57.9%) advised RTP at 3 to 6 months after hip arthroscopy. Conclusion: The overall rate of reported RTP was high after hip arthroscopy for FAI. However, more than one-fourth of athletes who returned to sports did not return at their preinjury level. Development of validated rehabilitation criteria for safe return to sports after hip arthroscopy for FAI could potentially improve clinical outcomes while also increasing rates of RTP at preinjury levels.

scholarly journals Arthroscopic Hip Surgery in the Elite Athlete: Comparison of Female and Male Elite Athletes

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0010
Author(s):  
Kotaro Shibata ◽  
Marc R. Safran
Keyword(s):  
Hip Arthroscopy ◽  
Elite Athletes ◽  
Hip Surgery ◽  
Return To Sports ◽  
Competitive Sports ◽  
Sports Activity ◽  
Competitive Activity ◽  
Sports Activities ◽  
Athlete Group

Objectives: 1) To compare ability to return to prior competitive sports activity after arthroscopic hip surgery by gender, with an emphasis on the rate of return to the same level of competition. 2) To compare gender differences in type of sports activities, diagnosis and treatment in athletes requiring hip arthroscopy. Methods: Prospectively obtained data on all high-level elite athletes (professional, NCAA collegiate and/or Olympic) treated between 2007 and 2014 were retrospectively reviewed. The clinical and surgical records of 547 hips in 484 consecutive patients who underwent primary hip arthroscopy by the senior author for non-arthritic hip pain during the study period were included. Elite athletes who had a Hip Sports Activity Score (HSAS) of over 6 were identified. Patients completed a pre-operative questionnaire that included medical and sports activity history and level of competition, hip-specific outcome scores (Modified Harris Hip Score [MHHS] and International Hip Outcome Tool-33 [iHOT-33]) at baseline and most recent follow-up. Surgical findings and time to return to competitive sports activity were documented. Results: A total of 98 elite athletes with a mean follow up period of 18.8 months (±12.7) were identified. There were 49 females and 49 males. 27 athletes had bilateral hip arthroscopy, 5 of which had 1 operation elsewhere. All patients were available for follow up. Of the 80 patients desiring to return to their original competitive activity, 38 were female (42 hips) (Female Athlete group [FA]) and 42 were male (54 hips) (Male Athlete group [MA]) their mean ages were 21.5(±3.9) and 20.5(±1.9), duration of pain prior to surgery was 12.1 (±10.3) months and 15.1 (±1.9) months, respectively. 84.2% of FA and 83.3% of MA were able to return to the same level of competition at a mean of 8.3 (±3) and 8.8 (±2.9) months, respectively. Statistically significant improvements between pre- and post-operative mean MHHS and iHOT-33 scores were seen in both groups (p <.0001; p <.0001). FA had significantly higher proportions of hips that were diagnosed with Pincer type FAI (p =.0004), and Instability (p <.0001). Conversely, the MA had significantly higher proportions of hips that were diagnosed with Combined type FAI (p <.0001), had more extensive acetabular cartilage rim damage (p =.0002), and in particularly had more hips that required microfracture treatment (p =.001). When comparing cam lesions (includes Cam and Combined type FAI) the alpha angle was statistically greater in MA (mean 74°±6.7) compared to FA (mean 65.4°±6.8) (p <.0001). The category of sports the FA participated in were more flexibility (11%) and endurance (24%) type sports. MA participated more in cutting (33%), contact (14%) and asymmetric (31%) type sports. Patients who were able to return to same level of competitive activity had a significantly shorter duration of pre-operation symptoms compared to those who could not (p < 0.05). Microfracture treatment did not affect the ability to return to sports. Conclusion: A similar high percentage of both female and male elite athletes were able to return to competitive sports activity after arthroscopic treatment of FAI and/or hip instability. Distinct differences in diagnosis, treatment and participating type of sports activities were seen when comparing female and male athletes. Duration of symptoms negatively correlated with outcomes. Extensive cartilage damage and Microfracture did not affect outcome / return to sports.

scholarly journals Osteochondral Lesions of the Talus: Few Patients Require Surgery

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0005
Author(s):  
Seung-Hwan Park ◽  
Sang Gyo Seo ◽  
Ho Seong Lee
Keyword(s):  
Osteochondral Lesion ◽  
Lesion Size ◽  
Nonoperative Treatment ◽  
Osteochondral Lesions ◽  
Sports Activity ◽  
Sf 36 ◽  
Outcome Scores ◽  
The Mean ◽  
Analogue Scales

Category: Ankle, Ankle Arthritis Introduction/Purpose: The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. We report the outcome of a nonoperative treatment for symptomatic OCL. Methods: This study included 142 patients with OCLs from 2003 to 2013. The patients did not undergo immobilization and had no restrictions of physical activities. The mean follow-up time was 6 (3–10) years. Initial MRI and CT confirmed OCL and showed lesion size, location, and stage of the lesion. Progression of osteoarthritis was evaluated by standing radiographs. In 83 patients, CT was performed at the final follow-up for analyses of the lesion size. We surveyed patients for limitations of sports activity, and Visual Analogue Scales (VAS), AOFAS, and SF-36 were assessed. Results: No patients had progression of osteoarthritis. The lesion size as determined by CT did not change in 69/83 patients, decreased in 5, and increased in 9. The mean VAS score of the 142 patients decreased from 3.8 to 0.9 (p < 0.001), the mean AOFAS ankle–hindfoot score increased from 86 to 93 (p < 0.001), and the mean SF-36 score increased from 52 to 72 (p < 0.001). Only 9 patients reported limitations of sports activity. The size and location of the lesion did not correlate with any of the outcome scores. Conclusion: Nonoperative treatment can be considered a good option for patients with OCL.

Comparison of Clinical and Radiographic Outcomes Between Central and Lateral Lesions After Osteochondral Autograft Transplantation for Osteochondritis Dissecans of the Humeral Capitellum

2017 ◽  
Vol 45 (14) ◽  
pp. 3331-3339 ◽  
Author(s):  
Takeshi Matsuura ◽  
Yusuke Hashimoto ◽  
Kazuya Nishino ◽  
Yohei Nishida ◽  
Shinji Takahashi ◽  
...  
Keyword(s):  
Osteochondritis Dissecans ◽  
Rate Of Return ◽  
Return To Sports ◽  
Central Group ◽  
Osteochondral Autograft ◽  
Radiographic Outcomes ◽  
Lateral Group ◽  
The Mean ◽  
Central Lesions

Background: Clinical studies have reported satisfactory results after osteochondral autograft transplantation (OAT) for central lesions of unstable osteochondritis dissecans (OCD) of the elbow. However, the outcomes after OAT for lateral lesions remain unclear. Hypothesis: The clinical outcomes of OAT would be better for central lesions than for lateral lesions. Study Design: Cohort study; Level of evidence, 3. Methods: The authors retrospectively evaluated 103 juvenile athletes (mean age, 13.2 years; range, 11-16 years) who underwent OAT for symptomatic OCD of the humeral capitellum from 2003 to 2014. Sixteen patients were excluded because they did not fit the inclusion criteria. The final cohort of 87 patients was divided by lesion type into central lesion (n = 43) and lateral lesion (n = 44) groups. When possible, a single large plug was created for grafting and trimmed to reconstruct the rounded joint surface. The clinical, radiographic, and magnetic resonance imaging outcomes were evaluated for each group at a mean follow-up of 43 months (range, 24-100 months). Results: There were no significant differences in the age, sex, height, weight, duration of symptoms, follow-up time, preoperative range of motion, or Timmerman and Andrews score between the 2 groups. The preoperative osteoarthritic changes (0 of 43 for central vs 5 of 44 cases for lateral; P = .023), mean lesion size (12.2 ± 2.9 vs 18.2 ± 7.0 mm; P < .001), and graft number (1.6 vs 2.8; P < .001) were significantly greater in the lateral group versus the central group. The mean range of extension (2.3° ± 5.4° vs −3.2° ± 8.7°; P < .001) and Timmerman and Andrews score (194 vs 185; P = .006) at the final follow-up were significantly better for patients in the central group. More patients in the lateral group had postoperative radial head subluxation (0 of 43 vs 6 of 44; P = .012) and osteoarthritic changes (1 of 43 vs 9 of 44; P = .008). The mean MOCART score showed no significant differences between the groups (78.0 ± 15.7 vs 72.6 ± 20.9; P = .181). The rate of return to sports at the previous level was 100% in the central group and 86% in the lateral group ( P = .012). Conclusion: The clinical and radiographic outcomes after OAT associated with unstable OCD of the humeral capitellum were better for central lesions than for lateral lesions. However, satisfactory outcomes and a high rate of return to sports were obtained for unstable lateral lesions after OAT.

High Satisfaction and Return to Sports After Total Shoulder Arthroplasty in Patients Aged 55 Years and Younger

2017 ◽  
Vol 45 (7) ◽  
pp. 1664-1669 ◽  
Author(s):  
Grant H. Garcia ◽  
Joseph N. Liu ◽  
Alec Sinatro ◽  
Hao-Hua Wu ◽  
Joshua S. Dines ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Rate Of Return ◽  
Return To Sports ◽  
Rates Of Return ◽  
Satisfaction Rate ◽  
Vas Score ◽  
High Satisfaction

Background: Young, active candidates for total shoulder arthroplasty (TSA) are a unique group of patients. Not only do they demand longevity and improved function, but they also desire a return to physical activities. Purpose: To determine the rate of return to sports in patients aged ≤55 years undergoing TSA. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective review of consecutive patients who underwent anatomic TSA at a single institution. Exclusion criteria included age at the time of surgery >55 years and <2 years of follow-up. All patients had end-stage osteoarthritis with significant glenohumeral joint space narrowing. The final follow-up consisted of a patient-reported sports questionnaire, American Shoulder and Elbow Surgeons (ASES) score, and visual analog scale (VAS) score. Results: From 70 eligible patients, 59 patients (61 shoulders) were included with an average follow-up of 61.0 months (range, 25-103 months) and average age at the time of surgery of 48.9 years (range, 25-55 years). The average VAS score improved from 5.6 to 0.9 ( P < .001), and the average ASES score improved from 39.3 to 88.4 ( P < .001). Forty-nine procedures (80.3%) were performed for a primary diagnosis of osteoarthritis. Four shoulders returned to the operating room; none were for glenoid loosening. There was a 93.2% satisfaction rate, and 67.7% of patients (n = 40) stated that they underwent their surgery to return to sports. Moreover, patients in 96.4% of shoulders (55/57) restarted at least 1 sport at an average of 6.7 months. Direct rates of return were as follows: fitness sports (97.2%), golf (93.3%), singles tennis (87.5%), swimming (77.7%), basketball (75.0%), and flag football (66.7%). Patients in 47 shoulders (82.4%) returned to a similar or higher level of sports; 90.3% returned to high-demand sports, and 83.8% returned to high upper extremity sports. There was no significant difference in rates of return to sports by body mass index, sex, age, preoperative diagnosis, revision status, and dominant extremity. Conclusion: In patients aged ≤55 years undergoing TSA, there was a 96.4% rate of return to ≥1 previous sports at an average of 6.7 months. Furthermore, at an average follow-up of 61.0 months, no patients needed revision of their glenoid component, despite an 83.8% rate of return to high upper extremity sports. While caution should still be advised in young, active patients undergoing TSA, these results demonstrate a high satisfaction rate and improved ability to return to most sports after surgery.

Arthroscopic Microfracture for Osteochondral Lesions of the Talus: Functional Outcomes at a Mean of 6.7 Years in 165 Consecutive Ankles

2019 ◽  
Vol 48 (1) ◽  
pp. 153-158 ◽  
Author(s):  
Seung-Won Choi ◽  
Gun-Woo Lee ◽  
Keun-Bae Lee
Keyword(s):  
Functional Outcomes ◽  
Short Form ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Osteochondral Lesions ◽  
Study Cohort ◽  
Arthroscopic Microfracture ◽  
Sf 36 ◽  
The Mean

Background: Arthroscopic microfracture for osteochondral lesions of the talus (OLT) has shown good functional outcomes. However, some studies have reported that functional outcomes deteriorate over time after surgery. Purpose: To use various functional scoring systems to evaluate functional outcomes in a large sample of patients with OLT treated by arthroscopic microfracture. Study Design: Case series; Level of evidence, 4. Methods: The study cohort consisted of 165 ankles (156 patients) that underwent arthroscopic microfracture for small to mid-sized OLT. The mean lesion size was 73 mm2 (range, 17-146 mm2), and the mean follow-up period was 6.7 years (range, 2.0-13.6 years). The Foot and Ankle Outcome Score (FAOS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale, visual analog scale (VAS) for pain, and 36-Item Short Form Health Survey (SF-36) were used to compare the functional outcomes between the preoperative and final follow-up assessments. Results: The mean FAOS significantly improved in regard to all subscores ( P < .001). The AOFAS ankle-hindfoot scale showed an improvement from 71.0 points (range, 47.0-84.0) preoperatively to 89.5 points (range, 63.0-100) at the final follow-up ( P < .001). The VAS score showed an improvement from 6.2 points (range, 4.0-9.0) preoperatively to 1.7 points (range, 0-6.0) at the final follow-up ( P < .001). The mean SF-36 score improved from 62.4 points (range, 27.4-76.6) preoperatively to 76.2 points (range, 42.1-98.0) at the final follow-up ( P < .001). Among 165 ankles, 22 ankles (13.3%) underwent repeat arthroscopic surgery for evaluation of repaired cartilage status. Conclusion: Arthroscopic microfracture showed good functional outcomes and improved quality of life with maintenance of satisfactory outcomes at a mean follow-up of 6.7 years. Therefore, arthroscopic microfracture seems to be reliable as a first-line treatment for OLT at an intermediate-term follow-up.

Sign in / Sign up

Export Citation Format

Share Document