[Early results of open mosaicplasty in osteochondral lesions of the talus].

Abstract

The aim of this study was to evaluate early results of open mosaicplasty for the treatment of talus osteochondral lesions associated with chronic complaints. The study included eight patients (1 male, 7 females; mean age 35 years; range 18 to 74 years) with osteochondral lesions of the talar dome. The mean duration of symptoms was 11 months and the mean lesion size was 17 x 9 mm. The lesions were of medial localization in five patients, and lateral localization in three patients. According to the Bristol classification, the stages of the lesions were as follows: stage IIa (n=2), IIb (n=1), III (n=2), IV (n=1), and V (n=2). Mosaicplasty was performed via a mini arthrotomy with osteotomy. Functional assessments were made using the AOFAS (American Orthopaedic Foot & Ankle Society) scoring system pre- and postoperatively. Pain was assessed using a visual analog scale. Regeneration of new cartilage tissue at the lesion site was monitored by magnetic resonance imaging. The mean follow-up was 17 months (range 8 to 34 months). The osteotomy site healed in a mean of six weeks in all the patients. The mean pre- and postoperative AOFAS scores were 58 (range 40-68) and 89 (range 80-97), respectively (p<0.005). Pain scores decreased from a mean of 8 (range 5 to 10) to 2 (range 1 to 4; p<0.005). Surgery-related complication was seen in one patient. All the patients returned to preoperative levels of activity and occupation. Magnetic resonance imaging showed graft incorporation in all the patients. Open mosaicplasty is a simple, safe, and effective alternative in the treatment of cartilage losses of the talar dome, in particular those of cystic type and exceeding 10 mm in size.