title: Arthroscopic treatment of osteochondral lesions of the tibial plafond.
abstract: BACKGROUND
  Osteochondral lesions of the distal tibial plafond (OLTPs) are an uncommon problem. The purpose of this study was to evaluate clinical outcomes following arthroscopic treatment of OLTPs.
  
  
  METHODS
  Retrospective chart review was performed on all patients treated arthroscopically for OLTPs. Treatment consisted of generalized synovectomy followed by curettage of the lesion and microfracture. If a cartilage cap was intact, antegrade drilling was performed. Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft.
  
  
  RESULTS
  A total of 13 patients were included. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. Average followup was 156 (range, 38 to 402 ± 117.9) weeks and average patient age was 32.9 (range, 14 to 50 ± 11.8) years. Eleven of 13 patients were available for followup modified AOFAS score. The average preoperative score was 35.2 (range, 24 to 49 ± 7.1). The average postoperative modified AOFAS score was 50.4 (range, 33 to 56 ± 7.6). There were four patients (30.8%) with a poor outcome.
  
  
  CONCLUSIONS
  OLTPs can be challenging to treat. Arthroscopic treatment can lead to improved outcomes. However, the higher incidence of poor outcomes in our series may indicate less predictability in the treatment of OLTPs and that outcomes may not be equivalent to previous reported studies on OLTPs or osteochondral lesions of the talus.
authors.affiliation: Orthopaedic Foot and Ankle Center, Westerville, OH, USA. ofacresearch@orthofootankle.com
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cuttica
authors.forename: W Bret
authors.initials: WB
authors.lastname: Smith
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Hyer
authors.forename: Terrence M
authors.initials: TM
authors.lastname: Philbin
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Berlet
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000601:surgery; D054544:Arthroplasty, Subchondral; D001182:Arthroscopy / Q000379:methods*; D001847:Bone Diseases / Q000473:pathology / Q000601:surgery; D002357:Cartilage Diseases / Q000473:pathology / Q000601:surgery; D002358:Cartilage, Articular / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D003560:Cysts / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D020127:Recovery of Function; D012189:Retrospective Studies; D013977:Tibia / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D055815:Young Adult