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Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
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Bone marrow stimulation for talar osteochondral lesions at long-term follow-up shows a high sports participation
Kaj T A Lambers1,2,3, Jari Dahmen1,2,3, J Nienke Altink1,2,3
1Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Summary
Most patients with osteochondral lesions of the talus (OCLT) resume sports after arthroscopic bone marrow stimulation (BMS). However, long-term follow-up shows a decline in ankle function and pain scores despite sustained sports participation.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Ankle biomechanics
Background:
- Osteochondral lesions of the talus (OCLT) can significantly impair athletic function.
- Arthroscopic bone marrow stimulation (BMS) is a common treatment for OCLT, with promising short-term return-to-sport rates.
- Long-term outcomes regarding sustained sports activity and functional decline after BMS for OCLT require further investigation.
Purpose of the Study:
- To evaluate the long-term sports activity and functional outcomes after arthroscopic bone marrow stimulation (BMS) for osteochondral lesions of the talus (OCLT).
Main Methods:
- A cohort of 60 patients who underwent arthroscopic debridement and BMS for OCLT was analyzed.
- Return to sport, level, and type were assessed at 1 year and final follow-up (mean 6.4 years).
- Standardized questionnaires evaluated pain (NRS), satisfaction, and the Foot and Ankle Outcome Score (FAOS).
Main Results:
- 90% of patients participated in sports at final follow-up, with 53% returning to their pre-injury level.
- Mean activity level (AAS) was maintained at final follow-up compared to pre-injury levels.
- While pain scores remained low, FAOS scores significantly decreased from 1-year to final follow-up.
Conclusions:
- Arthroscopic BMS for OCLT allows sustained sports participation in most patients long-term.
- A significant proportion of patients achieve their pre-injury level of sport, with maintained activity levels.
- Despite continued sports engagement, a decline in functional ankle outcomes is observed over time, highlighting the need for ongoing management.
