Mid-term Results after Arthroscopic Treatment of High-grade Osteochondral Talar Lesions with Platelet-rich Fibrin (PRF)
DOI:
https://doi.org/10.7546/CRABS.2024.11.13Keywords:
ankle arthroscopy, osteochondral lesions, platelet-rich fibrinAbstract
Arthroscopic treatment of high-grade osteochondral lesions of the talus is usually limited to retrograde drilling. Salvage options after failed marrow stimulation include osteochondral grafting. The biological potential of platelet-rich products is an opportunity to take a different path in impacting the course of these lesions.
There is limited evidence regarding platelet-rich fibrin (PRF) application in severe osteochondral talar lesions. The aim of this study was to present mid-term results after arthroscopic application of PRF in patients with high-grade talar lesions.
This is a retrospective study of 15 patients with osteochondral talar lesions. Ferkel and Sgaglione CT staging system as well as Berndt and Harty Radiographic Classification were utilized. Inclusion criteria was only stage IV lesions. The mean age was 34.2 years (SD: 5.2). Fifty-three percent of the patients (n = 8) were female. The Body Mass Index (BMI) ranged from 19 to 35. Mean BMI was 27 (SD: 4.4). The mean follow-up was 38.8 months (range, 35–42). The study was conducted in a single institution. All surgeries were performed by a single senior surgeon utilizing the same arthroscopic algorithm with PRF application. The Visual analogue scale (VAS), the American Orthopaedic Foot and Ankle Score (AOFAS), as well as complications rate were recorded.
Preoperative mean AOFAS score of 52.8 was converted to a mean score of 84.9 (p < 0.05). The mean VAS score ranged from 44.9 preoperatively to a 16.5 postoperative result (p < 0.05). Complications rate was 6.6% with one transient superficial infection.
Arthroscopic PRF application in high-grade osteochondral talar lesions showed good to excellent postoperative results, as well as a safe profile with low complications rate. Nevertheless confounding factors such as the lack of control group and the limited number of patients do exsist. More evidence is needed to acknowledge the findings of this study.
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