| Initial outcomes of 3-dimensional imaging-based computer-assisted retrograde drilling of talar osteochondral lesions. | |
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MedLine Citation:
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PMID: 19357106 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jens Geerling; Stefan Zech; Daniel Kendoff; Musa Citak; Padhraig F O'Loughlin; Tobias Hüfner; Christian Krettek; Martinus Richter |
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Publication Detail:
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Type: Journal Article Date: 2009-04-08 |
Journal Detail:
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Title: The American journal of sports medicine Volume: 37 ISSN: 1552-3365 ISO Abbreviation: Am J Sports Med Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-01 Completed Date: 2009-10-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7609541 Medline TA: Am J Sports Med Country: United States |
Other Details:
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Languages: eng Pagination: 1351-7 Citation Subset: IM |
Affiliation:
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Department for Trauma and Reconstructive Surgery, Diakoniekrankenhaus Friederikenstift, Hannover, Germany. jens.geerling@gmx.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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