Fluoroscope-assisted arthroscopic retroarticular drilling for osteochondral lesions of talus with bone grafting – Clinical outcome analysis and review of literature

Objectives: Early stages of osteochondral lesions with or without cystic changes are amenable to revitalization and cartilage restoration. In these cases, we assess the outcome using our standard technique and by eliminating the need for malleolar osteotomy. Materials and Methods: Seven cases of osteochondral lesion of talus were treated with retroarticular drilling under arthroscopy and fluoroscopy assistance. These cases were followed up for a minimum of 6 months (mean 20 ± 12.53 months). The functional outcome was assessed using American Orthopedic Foot and Ankle Score (AOFAS) hindfoot score. Results: The AOFAS increased from 49.28 (±6.7) points to 85 (±9.12) points and was noted to be statistically significant (P < 0.001). 2/7 ankles were lateral sided lesion and had a history of trauma. 6/7 cases had an intact intraoperative cartilage status, whereas one case had Grade C (fissures and fibrillation). However, the location of lesion or the grade of lesion did not influence the results. Conclusion: This treatment modality seems to be a feasible option for early lesions and can be considered before alternative cartilage replacement treatment strategies are employed.