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- Title
OSTEOCHONDRAL LESIONS OF THE TALUS: FACTORS PREDICTIVE OF CARTILAGE INTEGRITY.
- Authors
Perkins, Crystal A.; Erickson, John; Braithwaite, Kiery; Busch, Michael T.; Willimon, S. Clifton
- Abstract
Background: The integrity of articular cartilage in patients with osteochondral lesions of the talus (OLTs) guides treatment. The ability to predict cartilage integrity in OLTs, as previously published for OCD of the knee1, would be beneficial. The purpose of this study is to evaluate the association of radiographic and MRI findings and articular cartilage integrity at the time of ankle arthroscopy for OLTs. Methods: A single‐institution retrospective review identified patients 19 years of age and younger with operative treatment of OLTs from 2010 – 2017. Demographics and intra‐operative findings at the time of ankle arthroscopy were identified by chart review. Radiographs were assessed for physeal status, OLT location, and Berndt and Hardy grade. MRIs were reviewed for OLT size and location, modified Kramer grade, and cartilage status. Results: 53 patients with 54 OLTs and a mean age of 13.6 years (range 7 – 19 years) were included. OLTs were located in the posteromedial talus in 39 patients (72%). Physeal status was closed/closing in 32 patients (59%) and open in 22 patients (41%). On MRI, the cartilage was predicted to be disrupted in 40 patients (74%) and intact in 14 patients (26%). At the time of ankle arthroscopy, the cartilage was found to be disrupted in 38 OLTs (70%) and intact in 16 OLTs (30%). Table 1 lists variables predictive of cartilage integrity. Conclusions: Physeal status, radiographic grade, MRI grade, and cartilage integrity on MRI are independent predictors of cartilage integrity at the time of ankle arthroscopy for patients with OLTs. Overall, MRI has 95% sensitivity and 75% specificity for cartilage integrity at the time of arthroscopy, which improves to near 100% sensitivity and specificity in patients with open physes. A model combining MRI cartilage integrity, physeal status, and radiographic grade has the highest predictability of intra‐operative cartilage integrity.
- Subjects
ARIZONA; ANKLEBONE; ARTHROSCOPY; ARTICULAR cartilage; BONE diseases; CONFERENCES &; conventions
- Publication
Orthopaedic Journal of Sports Medicine, 2020, Vol 8, p305
- ISSN
2325-9671
- Publication type
Article
- DOI
10.1177/2325967120S00263