Akademik Veri Yönetim Sistemi
EKLEM HASTALIKLARI VE CERRAHISI-JOINT DISEASES AND RELATED SURGERY, cilt.30, sa.2, ss.97-105, 2019 (SCI-Expanded)
Objectives: This study aims to compare two single-step arthroscopic techniques, microfracture and cell-free scaffold implantation, in the treatment of talar osteochondral lesions (OCLs) clinically and radiologically. Patients and methods: This retrospective study included 62 patients (35 males, 27 females; mean age 41 +/- 13 years; range, 15 to 65 years) diagnosed with talar OCLs between March 2007 and January 2015. Patients who were followed-up with a minimum of 24 months with lesions larger than 1 cm(2) were included. Pre- and postoperative clinical evaluations were performed according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and radiological evaluations according to the magnetic resonance observation of cartilage repair tissue (MOCART) scale. Results: Patients were divided into microfracture (n=22) and scaffold (n=40) groups. The mean follow-up duration was 36.1 +/- 14.9 months. The mean preoperative AOFAS score increased from 60.6 +/- 13.9 to 82.1 +/- 11.8 in the microfracture group (p<0.001) and from 53.8 +/- 13.6 to 89.4 +/- 9.9 in the scaffold group (p<0.001). The scaffold group had superior results than the microfracture group clinically (p=0.011). Clinical results were superior in younger patients (<45 years) (p=0.018), male patients (p=0.020), and traumatic lesions (p=0.014). There was no significant difference between the two techniques according to the total MOCART scores (p=0.199). However, the scaffold technique was more successful in terms of lesion border and effusion subgoups of MOCART scale. Conclusion: Both single-step arthroscopic techniques are effective and safe in the treatment of talar OCLs. The scaffold technique showed superior clinical results than the microfracture technique in short-term follow-up. Age, trauma history and gender significantly affected the treatment outcomes. The scaffold technique can be considered as a safe and good alternative particularly in the treatment of large lesions.