Posterior ankle arthroscopic approach for the treatment of Raikin’s 7-8-9 osteochondral lesions of the talus

Abstract

Objective: Osteochondral injuries of the ankle are relatively rare lesions that primarily involve the cartilage and subchondral bone of the talus, and are presented with a variable incidence ranging from 0.09 to 4%. The aim of our study is to show the clinical results of a consecutive case series of osteochondral lesions of Zones 7,8,9 (Raikin) of the talus treated by posterior ankle arthroscopy. We hypothesize that posterior ankle arthroscopy is an effective means to treat posterior talar osteochondral lesion. Methods: We analyzed prospectively the performance of 24 patients who underwent posterior endoscopic treatment of osteochondral lesions of the talus. The average period of follow-up was 26.2 months (18-84). The Ankle and Hindfoot AOFAS score was used and Patient satisfaction is evaluated. Complementarily Visual Analog Scale was used to evaluate the clinical behavior of patients. Results: The average AOFAS score improved from 45.5 to 85.29 points. All patients were satisfied with the surgical outcome and would choose surgical treatment again if needed. Two minor immediate postoperative complications (8,33%) were observed: 1 ecchymosis and 1 transitory hypoesthesia of the heel; 50% of the patients presented with induration and pain in the portals within 2 months after the surgery; 25% of patients was unable to resume their prior physical activity level. Conclusion: The posterior arthroscopic approach is a safe and effective therapeutic alternative for the treatment of the posterior talar osteochondral lesion. Resection of the fragment by arthroscopic approach is technically simple, reproducible and safe with few complications, thus reducing the time of return to sport and/or work activity in relation to open procedures.