Hyperuricemia predicts adverse clinical outcomes after arthroscopic microfracture of osteochondral lesions of the talus.

Abstract

To investigate the correlation of serum uric acid levels with the clinical outcomes of arthroscopic microfracture in osteochondral lesions of the talus (OLTs) and determine the cut-off point for predicting outcomes. A total of 134 OLTs patients who underwent arthroscopic microfracture from November 2008 to June 2019 were included: 42 in the hyperuricemia group (≥ 420 μmol/L) and 92 in the non-hyperuricemia group (< 420 μmol/L). Clinical characteristics recorded and analyzed included Visual Analog Scale (VAS score), American Orthopaedic Foot & Ankle Society score (AOFAS), and 36-Item Short Form Health Survey score (SF-36). Logistic regression identified risk factors, and Receiver Operating Characteristic Curves (ROC) determined the serum uric acid cut-off value for predicting outcomes, which was prospectively validated. Significant improvement were observed in postoperative range of motion score, VAS score, AOFAS score, and SF-36 score across all patients (P < 0.05). However, the VAS score for the non-hyperuricemia group was lower; In contrast, the AOFAS and SF-36 scores were higher than the hyperuricemia group during the last visit (P < 0.05). Multivariate analysis identified age, serum uric acid, osteochondral defect size, and urate deposition as independent risk factors for clinical outcomes, and the cut-off value for the serum uric acid American Orthopaedic Foot & Ankle Society score 445 μmol/L with sensitivity and specificity of 87.25 % and 81.25 %, respectively. Additionally, the derivation set demonstrated a sensitivity of 85.71 % and specificity of 83.33 % in predicting poor outcomes. Hyperuricemia predicts adverse clinical outcomes after arthroscopic microfracture of osteochondral lesions of the talus, strict postoperative drop uric acid treatment, especially hyperuricemia OLTs serum uric acid levels ≥ 445μmol/L. Level IV, case series.