Osteochondral lesions of the talus with small cysts may not affect the outcome of arthroscopic microfracture: A systematic review and meta-analysis.

BACKGROUND

The optimal treatment of Osteochondral lesion of the talus (OLT) for subchondral bone cysts (SBCs) has not been finalized. The purpose of this systematic review and meta-analysis was to define whether OLT with small SBCs will affect the clinical outcomes of OLTs after arthroscopic microfracture.

METHODS

We searched the Embase, Cochrane Library and PubMed databases up to May 13, 2024 for eligible comparative studies. The methodological index for non-randomized studies (MINORS) were used for assessing the methodological quality. The Review Manager 5.4 software was applied to perform the statistical analysis.

RESULTS

A total of 4 studies involving 257 patients were included in this meta-analysis. No significant difference was noted in American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the improvement of Foot and Ankle Ability Measure- Activities of Daily Life (FAAM-ADL) and Foot and Ankle Ability Measure (FAAM-SP), Tegner Score and Visual Analogue Scale (VAS) between the cyst and noncyst group. The noncyst group was statistically significant in term of FAAM-ADL and FAAM-SP. Radiological outcomes in the cyst group had improved after arthroscopic microfracture.

CONCLUSIONS

Based on the results of the present study, there are no clinical differences with the technique of bone marrow stimulation between simple and cystic ostechondral lesions of talus with depth smaller than 5-6 mm, with respect to the medial part of talus and referring to age younger than 40 years old.

LEVEL OF CLINICAL EVIDENCE

Level 3.