Clinical outcomes of early weight-bearing after arthroscopic microfracture during the treatment of osteochondral lesions of the talus.

BACKGROUND

The time until weight-bearing after arthroscopic microfracture when treating osteochondral lesions of the talus (OLT) is very important to the clinical outcomes of the operation. However, there have been no consistent opinions regarding the optimal time to start weight-bearing postoperatively. Many opinions advocate that weight-bearing should begin not earlier than the sixth or eighth week postoperatively, whereas others point out that earlier weight-bearing could also obtain satisfactory outcomes. The purpose of our study was to evaluate the clinical outcomes of early weight-bearing after arthroscopic microfracture during the treatment of OLT.

METHODS

Fifty-eight ankles in 58 patients with a single OLT <2 cm(2) were retrospectively studied. All lesions were treated with arthroscopic debridement and microfracture under local anesthesia. After the operation, the patients were allowed to bear full weight under the protection of figure-8-shaped splints. The visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle--hindfoot scale were evaluated preoperatively and at six postoperative timepoints (1st day, 1st month, 3rd month, 6th month, 12th month, and 24th month). Patients were followed up for 24-52 months (mean (34.97 ± 7.33) months).

RESULTS

All 58 patients achieved excellent recovery with significant relief of their symptoms. The VAS score decreased from 7.31 ± 1.0 preoperatively to 0.95 ± 0.76 at the 24th month follow-up (P = 0.000), whereas the AOFAS score improved from 53.53 ± 8.57 preoperatively to 87.62 ± 5.42 at the 24th month follow-up (P = 0.000).

CONCLUSION

The successful clinical outcomes of this study demonstrated that early weight-bearing after the treatment of OLT with arthroscopic microfracture can be allowed.