OSTEOCHONDRAL AUTOLOGOUS TRANSPLANTATION VERSUS ARTHROSCOPIC DEBRIDEMENT WITH DRILLING IN THE TREATMENT OF TALAR...

The aim: To conduct a comparative analysis of the results of arthroscopic debridement with drilling (ADD) versus osteochondral autologous transplantation (OAT) in the treatment of talar osteochondral lesions and defects (OHLD) based on the assessment of the function of the ankle joint, the level of pain and changes in the range of movements (ROM) in the affected joint.

Materials and methods: The study included 40 patients with OHLD, with an average area of 3.14 cm2 and a depth of 1.15 cm, located in the posterior and middle medial part of the talus block. In the group 1 performed ADD. In group 2 - OAT. The results were evaluated before surgery, at 12 and 24 months. The level of pain to VAS, the function to AOFAS, the ROM in the joint were studied.

Results: After treatment, there was a significant reduction in pain with the best result in group 2 (p<0.05). AOFAS showed that after 12 and 24 months the functional state of the joint in group 2 was better than in group 1 (p<0.01). After 12 months, ROM increased significantly in both groups. After 24 months, there was no increase in ROM in group 1, and in group 2 the growth was statistically significant (p<0.01), which confirmed the higher prospects and stability of the result when performing OAT.

Conclusions: OAT is better than ADD for talar OHLD, provides maximum recovery of the joint surface, significantly reduces pain and improves ankle function.