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KMID : 0828620050090020206
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Journal of Korean Arthroscopy Society
2005 Volume.9 No. 2 p.206 ~ p.213
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Comparison of Arthroscopic Debridement and Multiple Drilling for Osteochondritis Dissecans of the Talus
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Kim Kyung-Tae
Kim Jin-Hak
Lee Song
Cho Gun-Ho
Choi Dae-Jung
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Abstract
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Purpose:To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling.
Materials and Methods:Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups.
Results:There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved 53.1±2.7 points preoperatively to 85.1±8.5 points postoperatively in group I and 54.6±6.8 to 80.7±8.5 points in group II. Subjective and functional scores was also improved 49.6±10.5 points preoperatively to 84.6±7.7 points postoperatively in group I and 50.7 9.2 to 83.0±9.6 points in group II. But there were no statistical significance between them.
Conclusions:Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.
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KEYWORD
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Talus, Osteochondritis Dissecans, Arthroscopy, Debridement, Multiple drilling
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