Assessment of Functional Outcome of Arthroscopic Microfractures for Osteochondral Defect of Talus

Osteochondral lesions of the talus (OLTs) are focal injuries of the articular cartilage and subchondral bone, most often secondary to ankle trauma. Arthroscopic microfracture has become the most widely used to evaluate the effectiveness of arthroscopic microfracture as a treatment for small, well-contained OLTs by stimulating marrow-derived repair tissue formation and assessing clinical as well as radiological outcomes.

Study Report: In our series, patients with symptomatic OLTs underwent arthroscopic microfracture and were evaluated clinically and radiologically. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, while postoperative repair in selected patients was assessed with magnetic resonance imaging (MRI) using the magnetic resonance observation of cartilage repair tissue scoring system. Postoperative rehabilitation included strict non-weight-bearing for the first 6 weeks, followed by gradual return to activity. Postoperatively, patients demonstrated significant improvement in AOFAS scores, reflecting enhanced pain relief, function, and alignment. MRI-based evaluation revealed satisfactory cartilage fill and surface congruity in most cases, correlating with clinical recovery. Better outcomes were observed in patients with smaller (<15 mm), contained lesions and those who adhered to the rehabilitation protocol. In contrast, larger or cystic lesions and poor compliance were associated with delayed recovery or persistent symptoms.

Arthroscopic microfracture is a safe, minimally invasive, and effective joint-preserving treatment for small OLTs, especially in young, active individuals. Careful patient selection, early intervention, and compliance with rehabilitation are critical to optimizing outcomes. Biologic augmentation may further enhance long-term durability of cartilage repair.