title: Critical three-dimensional factors affecting outcome in osteochondral lesion of the talus.
abstract: OBJECTIVE
  This study aimed to investigate the relationship between clinical outcomes, patient demographics and the 3D-geometric profiles of the osteochondral lesion of the talus (OLT) following arthroscopic debridement and bone marrow stimulation.
  
  
  METHODS
  Between 2005 and 2011, arthroscopic debridement and bone marrow stimulation were performed on 50 ankles with OLT mean age of 36.0 (19.1) years and mean follow-up time of 35.5 (20.2) months. Clinical data were assessed using validated Japanese Society of Surgery of the Foot scoring. An outcome was deemed unsatisfactory if the JSSF score was less than 80. Magnetic resonance imaging and X-rays were used to assess the 3D-geometric profiles of the OLT.
  
  
  RESULTS
  The mean preoperative and postoperative scores were 73.4 (13.6) and 89.6 (11.5), respectively (p < 0.001). Unsatisfactory outcomes were identified in 12 % of patients. Linear regression analyses showed that lesion depth and patient age were significantly negatively correlated with postoperative scores (p < 0.001). High prognostic significances were attributed to defect depth and age of patient, and cut-off values of 7.8 mm and 80 years, respectively, were recommended to avoid a postoperative score less than 80. No significant correlations between poor clinical outcome and the other lesion profiles or demographic factors were identified.
  
  
  CONCLUSIONS
  Using 3D-geometric and demographic profiles, defect depth and age of patient are essential prognostic factors in OLT and may act as a basis for preoperative surgical decisions. A lesion depth ≥ 7.8 mm and age ≥ 80 years predict an unsatisfactory outcome following arthroscopic debridement and bone marrow stimulation.
authors: Foot and Ankle Surgery, Department of Orthopaedic Surgery, Faculty of Medicine, Thammasat University, Paholyothin road, Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand. chatthara@yahoo.com
authors: Chayanin
authors: C
authors: Angthong
authors: Ichiro
authors: I
authors: Yoshimura
authors: Kazuki
authors: K
authors: Kanazawa
authors: Akinori
authors: A
authors: Takeyama
authors: Tomonobu
authors: T
authors: Hagio
authors: Takahiro
authors: T
authors: Ida
authors: Masatoshi
authors: M
authors: Naito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054544:Arthroplasty, Subchondral; D001182:Arthroscopy; D001847:Bone Diseases / Q000175:diagnosis* / Q000601:surgery; D002357:Cartilage Diseases / Q000175:diagnosis* / Q000601:surgery; D002358:Cartilage, Articular / Q000601:surgery*; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013628:Talus / Q000601:surgery*; D055815:Young Adult