Lift, drill, fill and fix (LDFF): a new arthroscopic treatment for talar osteochondral defects.
OBJECTIVE
The purpose of this study was to describe the short-term clinical outcome of a new arthroscopic fixation technique for primary osteochondral talar defects: lift, drill, fill and fix (LDFF).


METHODS
Seven patients underwent an arthroscopic LDFF surgery for osteochondral talar defects, the mean follow-up was 12 months (SD 0.6). Pre- and postoperative clinical assessment included the American Orthopaedic Foot and Ankle Society Score (AOFAS) and the numeric rating scales (NRS) of pain at rest and during walking. Remodelling and bone ingrowth after LDFF were analysed on weight-bearing radiographs during follow-up.


RESULTS
In all patients, LDFF led to an improvement of the AOFAS and NRS of pain. The AOFAS significantly improved from 63 to 99 (p < 0.001). The NRS of pain at rest significantly improved from 2.9 to 0.1 (p = 0.004), and pain with walking significantly improved from 7.6 to 0.1 (p < 0.001). On the final radiographs, five of seven patients showed remodelling and bone ingrowth after LDFF.


CONCLUSIONS
The LDFF of an osteochondral talar defect appears to be a promising arthroscopic treatment option for primary talar osteochondral defects. Although the clinical and radiological results of 1-year follow-up are encouraging, more patients and longer follow-up are needed to draw any firm conclusions and determine whether the results stand the test of time.


METHODS
Prospective case series. Therapeutic, Level IV.
Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. g.m.kerkhoffs@amc.nl.
G M M J
GM
Kerkhoffs
Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. m.l.reilingh@amc.nl.
M L
ML
Reilingh
Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
R M
RM
Gerards
Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
P A J
PA
de Leeuw
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D010007:Osteochondritis / Q000209:etiology / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care / Q000379:methods; D011446:Prospective Studies; D013628:Talus / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult
Ankle; Arthroscopy; Cartilage-saving procedure; LDFF; Talar OCD