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May 2

Osteochrondral Defects of the Talus

Fluoroscopy-Guided Retrograde Core Drilling and Cancellous Bone Grafting in Osteochrondral Defects of the Talus
A study was performed to evaluate the outcomes of minimally invasive fluoroscopy-guided retrograde core drilling and autologous cancellous bone grafting in undetached osteochondral lesions (OCL) of the talus. The procedure was applied to 41 OCL of the talus in 38 patients, and the treated lesions were then assessed by clinical scores and magnetic resonance imaging (MRI). The average time for follow-up was 29 months, plus or minus 13 months. A significant increase in the AOFAS score from 47.3 plus or minus 15.3 points to 80.8 plus or minus 18.6 points was recorded. The outcomes for grade I and grade II lesions tended to be superior to those for grade III lesions, while first-line treatments and open distal tibial growth plates led to substantially improved results. Score results were not influenced by age, gender, body-mass index, time to follow-up, defect localization, or a traumatic origin. Pain intensity fell from 7.5 plus or minus 1.5 to 3.7 plus or minus 2.6 on a visual analog scale, while subjective function rose from 4.6 plus or minus 2 to 8.2 plus or minus 2.3. Five patients exhibited a complete bone remodeling in MRI follow-ups, while demarcation was detectable in two cases.

From the article of the same title
International Orthopaedics (04/10/12) Anders, Sven; Lechler, Philipp; Rackl, Walter; et al.

below are pictures from Dr Wrotslavsky showing  osteochondral lesions (OCL) of the talus