Osteochondral lesions of the talus: are there any differences between osteochondral and chondral types?
BACKGROUND
Among the types of osteochondral lesions of the talus (OLTs), the osteochondral and chondral types make up the majority of OLTs. There is a possibility that between these two types of lesions, the clinical outcomes and characteristics may differ.


OBJECTIVE
This study was designed to compare the clinical outcomes, demographics, and characteristics of osteochondral- and chondral-type lesions of OLTs.


METHODS
Cohort study; Level of evidence, 3.


METHODS
The authors retrospectively analyzed 298 ankles that underwent arthroscopic marrow-stimulating procedures for OLTs between 2001 and 2009 that had been arthroscopically determined as either chondral type (210 ankles) or osteochondral type (88 ankles). Clinical outcomes, demographics, and characteristics of the lesions were compared.


RESULTS
The age distribution showed that the chondral type reached its peak in patients in their 50s, whereas the osteochondral type had a peak distribution for those in their 20s. The average duration of symptoms was greater in the chondral type (28.3 months; range, 7-240 months) than in the osteochondral type (14.4 months; range, 8-120 months) (P < .001). With regard to the characteristics of the lesions, differences only existed in the combined intra-articular lesions between the two types. Subchondral cysts (odds ratio [OR], 3.71; 95% CI, 1.61-8.55; P = .001) and soft tissue impingement (OR, 1.82; 95% CI, 1.10-3.03; P = .021) were more frequently present in the chondral type. The American Orthopaedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) for pain showed significant improvement from preoperative to postoperative scores in both groups. However, the preoperative and postoperative VAS and AOFAS scores did not differ significantly between the groups.


CONCLUSIONS
Differences were found with age distribution, duration of symptoms, and combined intra-articular lesions between the osteochondral- and chondral-type lesions of OLTs. We achieved similar successful clinical outcomes in both types of lesions using arthroscopic marrow stimulating procedures, such as microfracture or abrasion arthroplasty.
Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, South Korea.
Gi Won
GW
Choi
Woo Jin
WJ
Choi
Hyun Kook
HK
Youn
Yoo Jung
YJ
Park
Jin Woo
JW
Lee
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D054544:Arthroplasty, Subchondral; D001182:Arthroscopy; D001265:Athletic Injuries / Q000145:classification* / Q000453:epidemiology; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D015331:Cohort Studies; D003560:Cysts / Q000453:epidemiology; D005260:Female; D006801:Humans; D007594:Joint Loose Bodies / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000453:epidemiology; D013628:Talus / Q000293:injuries* / Q000601:surgery; D013997:Time Factors; D055815:Young Adult