Comparison of medial osteochondral lesions of the talus characteristics between chronic lateral ankle instability and ankle varus.

PURPOSE

The objective is to compare the demographics and characteristics of medial osteochondral lesions of the talus (OLTs) between chronic lateral ankle instability (CLAI) and ankle varus.

METHODS

A total of 175 consecutive patients who underwent surgical intervention for medial OLTs between January 2010 and December 2022 were recruited. Patient demographic data including age, sex, side of injury, symptom duration, body mass index (BMI), history of ankle sprain, presence of CLAI, and ankle varus were documented. Lesion-related characteristics, including lesion size, anatomical location, Hepple classification, and presence of combined lesions, were also recorded. Patients were stratified into three groups: C (CLAI alone), V (ankle varus alone), and CV (CLAI and ankle varus). Statistical analyses were performed to compare demographic characteristics and lesion-related variables among the groups.

RESULTS

Group V had the highest median age (62.00 years; IQR, 52.75–68.25) and median duration of symptoms (36 months; IQR, 22.50–60.00), both significantly higher than group C. Group CV showed the highest median BMI (26.48; IQR, 24.73–30.68). In contrast, group C had the smallest mean size of lesions (113.7mm; IQR, 88.5–139.0) and the lowest proportion of the Hepple V classification (15.7%) .

CONCLUSION

Patients with ankle varus were older and had prolonged symptom duration compared to those with CLAI alone. Conversely, the latter group demonstrated a reduced prevalence of lesions measuring ≥ 150 mm² and lower rates of Hepple V classification.

LEVEL OF EVIDENCE

Level III, Casecontrol study.