Arthroscopic drilling results of talus osteochondral lesions

Patients with osteochondral lesions are more often young and active. Appropriate diagnosis and treatment should be started as soon as possible. There are multiple treatment modalities, but proper treatment method for different clinical situations is not clear. Recent medical articles were analized; biomaterials and stem cell researches were noted down.Ankle arthritis may occur after late diagnosis and treatment of osteochondral lesions.This study was perfomed at Celal Bayar University, Faculty of Medicine, Orthopedics and Traumatology Clinic. The population consists of 37 patients with osteochondral lesions at talus which were operated with arthroscopic drillng.In our study group, there were 29 male and 8 female patients (n=37), and the mean age was 36,51 (16 - 63). The mean follow-up time was 43,30 months (12 - 120). The mean length of the period from the first injury till operation, from first symptoms till operation was 35,22 (2 - 276) and 13,43 months respectively. The mean length of the conservative treatment was 2,19 months (1 - 4).23 patients (62,2 %) had right and 14 patients (37,8 % ) left ankle lesions.There were 12 (32,4%) lesions on the anteriomedial aspect of the talus, the 9 (24,3%) anterolaterally, 4 (10,8%) talar dome and 12 (32,4%) posteomedial.Out of 37 patients 27 had major trauma (73%). All of the laterally localised 9 lesions had a history of trauma. 9 of them were male. But the relation between major trauma and lateral lesions in male patients was statistically insignificant. (p=0,156)İn fact, the relation between lateral lesions and history of major trauma was statistically significant (p=0039). But post-operative ankle arthritis in 8 patients and major trauma had no significant relation (p=1,000).Only 5 patient (13,5) has additional disease. İnterestingly only 3 of them got arthritis at post-operative follow up (p=0,057). It could be significant, if there were high number of population.Body mass index (BMİ) of the patient were calculated as well. 8 Patients with arthritis had a mean value of 28,319 (25,04 - 35,95). The other 29 patients had a mean value of 26,3953 (20,20 - 33,26). There were no significant relationship between arthritis and BMİ (p=0,055).There was an improvement of AOFAS and VAS scores in 33 patients. And the radiologic grade scaled down. These post-operative improvements were also statistically significant.(p=0.0000), which is directly related to patients satisfaction with treatment. 8 patients got ankle arthritis at post-operative follow up, and their scores got lower values and radiological grades were higher.After investigation of 8 patients with arthritis, we couldn?t find out statistically significant causes. But BMİ, gender, and additional diseases are possible casualties.