The influence of limited postoperative weight-bearing on the outcome of drilling in osteochondritis dissecans tali.
BACKGROUND
This prospective study was performed to assess the influence of limited weight-bearing on the outcome of osteochondral drilling in the treatment of an osteochondritis dissecans tali.


METHODS
Of a total of 85 patients, 68 (80%; 37 male, 31 female, average age 28 years) were followed up after open or arthroscopic drilling between July 1990 and March 2000. The total outcome of 6 weeks limited postoperative weight-bearing (n=26) was compared with the outcome of 12 weeks limited weight-bearing (n=42). The average follow-up time was 4.8 years after surgery.


RESULTS
A significant increase (p<0.01) in the HSS and AOFAS scores was found for the entire study group ranging from HSS: 82 points; AOFAS: 68 points before surgery to HSS: 94 points; AOFAS: 90 points at the time of assessment. The duration of limited weight-bearing did not significantly influence the outcome of surgery. Through osteochondral drilling, the average AOFAS score increased 20 points (73/93) and the HSS score 12 points (84/96) in the 6-week group and the AOFAS score 23 points (65/88) and the HSS score 12 points (80/92) in the 12-week group. The total outcome between the two postoperative treatment regimens showed no significant difference.


CONCLUSIONS
Osteochondral drilling is an adequate therapy for osteochondritis dissecans tali. The postoperative duration of limited weight-bearing does not significantly influence the surgical outcome.
Bohnsack
Michael
M
Department of Orthopedic Surgery, Hannover Medical School, Anna-Von-Borries-Str. 1-7, 30625 Hannover, Germany. bohnsack@annastift.de
Fischer
Julia
J
Lipka
Wolfram
W
Schmolke
Stefan
S
Börner
Constanze
C
Wirth
Carl Joachim
CJ
Rühmann
Oliver
O
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D002648:Child; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000534:rehabilitation / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors; D016474:Weight-Bearing