The influence of limited postoperative weight-bearing on the outcome of drilling in osteochondritis dissecans tali

Arch Orthop Trauma Surg. 2003 Nov;123(9):447-50. doi: 10.1007/s00402-003-0550-8. Epub 2003 Jul 1.

Abstract

Introduction: This prospective study was performed to assess the influence of limited weight-bearing on the outcome of osteochondral drilling in the treatment of an osteochondritis dissecans tali.

Materials and methods: Of a total of 85 patients, 68 (80%; 37 male, 31 female, average age 28 years) were followed up after open or arthroscopic drilling between July 1990 and March 2000. The total outcome of 6 weeks limited postoperative weight-bearing (n=26) was compared with the outcome of 12 weeks limited weight-bearing (n=42). The average follow-up time was 4.8 years after surgery.

Results: A significant increase (p<0.01) in the HSS and AOFAS scores was found for the entire study group ranging from HSS: 82 points; AOFAS: 68 points before surgery to HSS: 94 points; AOFAS: 90 points at the time of assessment. The duration of limited weight-bearing did not significantly influence the outcome of surgery. Through osteochondral drilling, the average AOFAS score increased 20 points (73/93) and the HSS score 12 points (84/96) in the 6-week group and the AOFAS score 23 points (65/88) and the HSS score 12 points (80/92) in the 12-week group. The total outcome between the two postoperative treatment regimens showed no significant difference.

Conclusion: Osteochondral drilling is an adequate therapy for osteochondritis dissecans tali. The postoperative duration of limited weight-bearing does not significantly influence the surgical outcome.

MeSH terms

  • Adolescent
  • Adult
  • Arthroscopy
  • Child
  • Exercise Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteochondritis Dissecans / rehabilitation
  • Osteochondritis Dissecans / surgery*
  • Postoperative Period
  • Prospective Studies
  • Time Factors
  • Weight-Bearing*