Treatment of Osteochondral Lesions of the Talus with Transmalleolar Open Mosaicplasty

INTRODUCTION: To evaluate middle-term outcomes of patients that underwent open mosaicplasty due to osteochondral lesions of the talus causing chronic complaints.
METHODS: The retrospective study included 23 patients that were diagnosed with a Grade III, IV, and V osteochondral lesion of the talus according to the Bristol classification system between January 2014 and December 2017. Pain assessment was performed using Visual Analog scale (VAS 1-10) and functional outcomes were assessed using the AOFAS (American Orthopedic Foot & Ankle Society) Ankle-Hindfoot Rating System. Additionally, a questionnaire was filled out by each patient both preoperatively and at 1 year postoperatively.
RESULTS: Mean AOFAS score was 55.652 preoperatively and was 88.913 postoperatively and a significant difference was found between the two scores (p<0.001). Similarly, mean VAS score was 7.39 preoperatively and was 2.04 postoperatively and a significant difference was found between the two scores (p<0.001).
DISCUSSION AND CONCLUSION: Open mosaicplasty appears to be a useful technique for the treatment of cystic osteochondral lesions of the talar dome larger than 10 mm in diameter. The technique is also safe and effective and allows successful closure of the cartilaginous loss with hyaline cartilage.