We compared the clinical results between arthroscopic multiple drilling and autologous osteochondral grafting for osteochondral lesions of the talus.

Twelve patients underwent arthroscopic multiple drilling that left the remaining cartilage at the lesions, and ten patients underwent autologous osteochondral grafting for detached cartilage lesions. We performed a modified Brostrom procedure for 9 of the cases with combined lateral ankle instability in both groups. The average follow-up period was 12.4 months. The mean ages were 31 and 28 years old, respectively. The results were compared between the two groups by assessing the AOFAS scores and patient satisfaction, based on subjective symptoms.

The mean pre-operative AOFAS scores were 70 in the arthroscopic multiple drilling group and 70.3 in the autologous osteochondral grafting group. The post-operative AOFAS scores were 78.8 in the arthroscopic multiple drilling group and 93.5 in the autologous osteochondral grafting group (p<0.05). Patient satisfaction after multiple drilling was good in 3 cases, fair in 4 cases, poor in 5 cases, and pre-operative symptoms were not improved at all in 4 cases. After autologous osteochondral grafting, 7 cases were good and 3 were fair.

The study demonstrated that in the treatment of osteochondral lesions of the talar dome, the results of autologous osteochondral grafting were superior to those of arthroscopic multiple drilling.