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Impact of Early Weightbearing After Ankle Arthroscopy and Bone Marrow Stimulation for Osteochondral Lesions of the Talus.

Publication ,  Journal Article
Danilkowicz, RM; Grimm, NL; Zhang, GX; Lefebvre, TA; Lau, B; Adams, SB; Amendola, A
Published in: Orthop J Sports Med
September 2021

BACKGROUND: Osteochondral lesion of the talus (OLT) may be caused by osteochondritis dissecans, osteochondral fractures, avascular necrosis, or focal arthritic changes. For certain focal cartilage defects, bone marrow stimulation (BMS) has been a widely used technique to restore a fibrocartilage substitute overlying the defect. There are various postoperative weightbearing protocols for this procedure, with no single gold standard method. PURPOSE: To retrospectively review the outcomes of patients undergoing ankle arthroscopy with concomitant BMS to determine outcomes based on postoperative weightbearing status. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively reviewed the records of patients who underwent ankle arthroscopy with BMS for OLTs between 2015 and 2018. Patients were placed into 2 cohorts based on postoperative immobilization status: the nonweightbearing (NWB) group and the weightbearing-as-tolerated (WBAT) group. Patient characteristics obtained included age, sex, comorbidities, and etiology of talar pathology. Outcomes included the pain visual analog scale (VAS), range of motion (ROM), complications, time to first weightbearing, and the method and length of immobilization. Patients who were lost to follow-up before 30 days were excluded. The chi-square test was used to compare categorical variables between cohorts, and the t test was used for continuous variables. RESULTS: A total of 69 patients met the inclusion criteria for this study, 18 in the WBAT group and 51 in the NWB group. The mean lesion size was 9.48 × 9.21 mm (range, 3-15 mm × 2-20 mm) for the NWB group and 9.36 × 9.72 mm (range, 5-14 mm × 6-20 mm) for the WBAT group (P > .05). The VAS scores improved from 4.40 to 0.67 for the WBAT group and from 6.33 to 2.55 for the NWB group, with the difference in final values reaching statistical significance (P = .0002). Postoperative ROM was not significantly different between the groups. There were 4 repeat operations within the NWB cohort. CONCLUSION: The surgical management of OLTs can be challenging, and the postoperative weightbearing protocol can be an extra obstacle for the patient to navigate. We found no difference in pain, ROM, or complications when allowing immediate, full WBAT.

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Published In

Orthop J Sports Med

DOI

ISSN

2325-9671

Publication Date

September 2021

Volume

9

Issue

9

Start / End Page

23259671211029883

Location

United States

Related Subject Headings

  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences
 

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Danilkowicz, R. M., Grimm, N. L., Zhang, G. X., Lefebvre, T. A., Lau, B., Adams, S. B., & Amendola, A. (2021). Impact of Early Weightbearing After Ankle Arthroscopy and Bone Marrow Stimulation for Osteochondral Lesions of the Talus. Orthop J Sports Med, 9(9), 23259671211029884. https://doi.org/10.1177/23259671211029883
Danilkowicz, Richard M., Nathan L. Grimm, Gloria X. Zhang, Thomas A. Lefebvre, Brian Lau, Samuel B. Adams, and Annunziato Amendola. “Impact of Early Weightbearing After Ankle Arthroscopy and Bone Marrow Stimulation for Osteochondral Lesions of the Talus.Orthop J Sports Med 9, no. 9 (September 2021): 23259671211029884. https://doi.org/10.1177/23259671211029883.
Danilkowicz RM, Grimm NL, Zhang GX, Lefebvre TA, Lau B, Adams SB, et al. Impact of Early Weightbearing After Ankle Arthroscopy and Bone Marrow Stimulation for Osteochondral Lesions of the Talus. Orthop J Sports Med. 2021 Sep;9(9):23259671211029884.
Danilkowicz, Richard M., et al. “Impact of Early Weightbearing After Ankle Arthroscopy and Bone Marrow Stimulation for Osteochondral Lesions of the Talus.Orthop J Sports Med, vol. 9, no. 9, Sept. 2021, p. 23259671211029884. Pubmed, doi:10.1177/23259671211029883.
Danilkowicz RM, Grimm NL, Zhang GX, Lefebvre TA, Lau B, Adams SB, Amendola A. Impact of Early Weightbearing After Ankle Arthroscopy and Bone Marrow Stimulation for Osteochondral Lesions of the Talus. Orthop J Sports Med. 2021 Sep;9(9):23259671211029884.
Journal cover image

Published In

Orthop J Sports Med

DOI

ISSN

2325-9671

Publication Date

September 2021

Volume

9

Issue

9

Start / End Page

23259671211029883

Location

United States

Related Subject Headings

  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences