gms | German Medical Science

Microfracturing has become increasingly widespread for the therapy of discrete cartilage defects. The objective of this prospective study was to evaluate the clinical and radiological results after microfracturing in chondral and osteochondral damage to the Talus.

Between April 2000 and December 2003, 91 patients with discrete cartilage defects were treated by microfracturing in the upper ankle. A common microfracturing set with variously curved awls was used. The 56 men and 35 women were on average 31.3 years old (21 - 52 years) and had presented with symptoms for 13 months (6 - 27 months). In 29 cases, the Talus defect was lateral, in 62 cases medial. The mean size was 1.4 qm. Preoperative, an MRT was performed in all patients and could be repeated in all patients after 6 and 12 months. The extent of pain, extent of movement, activity level and the patient's quality of life were evaluated pre- and postoperative using the AOFAS Score, the Pförringer Score, the Kofoed Ankle Score and the Tegner-Activities Index.

78 of the 86 patients who were available for follow-up were satisfied or more than satisfied with the outcome. All of the subjective, semiobjective or objective parameters included in the scores showed improvement. The magnetic resonance tomography examination after 6 months showed healed cartilage surfaces, but there were still marked signal irregularities.

Microfracturing appears to be an efficient treatment technique for traumatic or degenerative discrete chondral defects of the Talus. Although the defects only fill with fiber cartilage which does not have the biological and mechanical properties of the original tissue, the clinical result of this treatment method is good to excellent in the majority of the cases treated.