Clinical Results of the Multiple Drilling for Osteochondral Lesion of the Medial Talar Dome

Chung Soo Han; Duke Whan Chung; Jung Chul Hwang; Hyung Jun Cho

doi:10.4055/jkoa.2007.42.6.750

Journal List > J Korean Orthop Assoc > v.42(6) > 1012728

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Han, Chung, Hwang, and Cho: Clinical Results of the Multiple Drilling for Osteochondral Lesion of the Medial Talar Dome

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(6): 750-755.

Published online: 31 December 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.6.750

Clinical Results of the Multiple Drilling for Osteochondral Lesion of the Medial Talar Dome

Chung Soo Han, M.D., Duke Whan Chung, M.D., Jung Chul Hwang, M.D., Hyung Jun Cho, M.D.

Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Address reprint requests to Duke Whan Chung, M.D. Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +82.2-958-8368, Fax: +82.2-964-3865, dukech@khmc.or.kr

Abstract

Purpose

To evaluate the treatment outcomes of transmalleolar multiple drilling with a K-wire for an osteochondral lesion of the medial talar dome after an mean follow-up period of 77 months.

Materials and Methods

Among patients treated surgically for a symptomatic osteochondral lesion of the talus between March 1997 and December 2002, sixteen ankles (fifteen patients) with a medial talar dome lesion were treated by transmalleolar multiple drilling and followed-up for at least 3 years. The average age at the time of surgery was 34.4 years (range, 19-58 years). The mean follow-up period was 77 months (range, 41-107 months).

Results

At the latest follow-up, the average VAS at motion decreased from 6.8 to 2.1 (p=0.004). The AOFAS score improved from 64 points to 86.2 points (p=0.001). The 8 ankles in those less than thirty years of age at that time of surgery showed a VAS at motion of 1.8 and an AOFAS score of 91.1 points. In contrast, 8 ankles in those who older than thirty one years of age had a VAS at motion of 2.4 and an AOFAS score of 81.2 points. The younger group showed a significantly better AOFAS score than the older group (p=0.001). However, there was no significant difference in the VAS score (p=0.22).

Conclusion

Multiple drilling has a good effect in pain control and ankle function for patients with an osteochondral lesion of the medial talar dome 10 mm. The procedure is particularly effective and useful in younger patients.

Keywords: Talus, Medial talar dome, Osteochondral lesion, Multiple drilling

Figures and Tables

Table 1

Patient Demographics

Table 2

Correlation between Age and the Postoperative Score

Table 3

Correlation between the Duration of Symptoms and the Postoperative Score

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