Document Detail


Initial outcomes of 3-dimensional imaging-based computer-assisted retrograde drilling of talar osteochondral lesions.
MedLine Citation:
PMID:  19357106     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In operative treatment of Berndt and Harty stage 1 and stage 2 osteochondral lesions of the talus, the goal is revascularization. The use of computer-assisted guided retrograde drilling of osteochondral lesions has been described as a new technique with promising results. PURPOSE: This study reports the follow-up assessment of patients treated with Iso-C-3D-navigated retrograde drilling. Its aim was to establish whether the greater precision of computer-assisted drilling results in satisfactory clinical outcomes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Patients who underwent navigated Iso-C-3D-based retrograde drilling between June 1, 2003, and July 31, 2005, were included in the follow-up study. Clinical outcomes were measured using (1) the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society and (2) the Visual Analogue Scale-Foot and Ankle. Radiological outcomes were assessed via radiographs and magnetic resonance imaging. Surgeon satisfaction was assessed using a simple 0 to 10 rating scheme for feasibility, accuracy, and clinical benefit. RESULTS: Average follow-up time was 25 months (range, 20-34). Twenty patients satisfied the inclusion criteria: 12 men and 8 women; mean age, 35 years (range, 19-58). One patient was excluded because he required a cartilage restoration procedure. All scores improved at the time of follow-up-Ankle-Hindfoot Scale, from 76 to 90 (P < .001); Visual Analogue Scale-Foot and Ankle, from 79 to 92 (P < .001). The average ratings of the operating surgeons (n = 3) were as follows: feasibility 9.0 (range, 7.3-10.0); accuracy, 8.5 (range, 5.8-10.0); and clinical benefit, 8.5 (5.7-10.0). At follow-up, magnetic resonance imaging revealed an improvement of the Hepple score in 80% of patients. CONCLUSION: Arthroscopic treatment of osteochondral lesions of the talus is well established. A retrograde approach does not breach the overlying intact talar cartilage. The results of this follow-up study of 3-dimensional computer navigated drilling are promising.
Authors:
Jens Geerling; Stefan Zech; Daniel Kendoff; Musa Citak; Padhraig F O'Loughlin; Tobias Hüfner; Christian Krettek; Martinus Richter
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Publication Detail:
Type:  Journal Article     Date:  2009-04-08
Journal Detail:
Title:  The American journal of sports medicine     Volume:  37     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-01     Completed Date:  2009-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1351-7     Citation Subset:  IM    
Affiliation:
Department for Trauma and Reconstructive Surgery, Diakoniekrankenhaus Friederikenstift, Hannover, Germany. jens.geerling@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Ankle Injuries / surgery*
Arthroscopy / methods*
Female
Humans
Imaging, Three-Dimensional*
Magnetic Resonance Imaging
Male
Middle Aged
Osteochondrosis / diagnosis,  pathology*,  surgery
Recovery of Function
Surgery, Computer-Assisted*
Talus / physiopathology*,  surgery
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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