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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2005 June;29(2):61-6
Post-traumatic osteochondral lesions of the arthroscopically treated ankle
Guido G., Azzone R., Giannotti S., Donati L.
Aim. Personal experience in the arthroscopic treatment of osteochondral lesions of the ankle is reported. The authors are aware that, if not diagnosed early, such post-traumatic osteochondral lesions can manifest ingravescent, chronic, insidious symptomatology. Studies on the subject are examined chronologically and the modalities with which the pathology can occur are analysed.
Methods. A study carried out over a four-year period is examined. The clinical study, backed up by diagnostic and instrumental findings (standard X-ray, functional X-ray and NMR) suggests the correct diagnosis, and on this basis arthroscopic treatment is carried out. The Berndt and Harty classification for the staging of osteochondral lesions, adopted by the present authors, is accompanied by various evaluation systems such as that proposed by Ferkel-Sgaglione based on CT, NMR or Cheng-Ferkel images on the arthroscopic observation of the lesion.
Results. From 1999 to January 2003 the authors operated 30 patients arthroscopically for post-traumatic osteochondral lesions of the ankle. Of these 24 were male and 6 female aged between 18 and 50 years old, average 30. Average follow-up was 18 months. The authors propose arthroscopy if pain symptomatology persists in spite of medical and physical treatments, and abstention from sporting activities, and in stages 2-3-4 of Berndt-Harty. All patients were assessed according to the evaluation proposed by Loomer. From the series it emerged that about 85% of the cases treated arthroscopically presented good results, with disappearance of pain, and resumption of working and sporting activities.
Conclusion. Having analysed the advantages of arthroscopy as opposed to arthrotomy, and given the good results, the authors state that, where correctly indicated, ankle arthroscopy can be considered a first choice technique in so far as it is resolutive in the treatment of the osteochondral lesions in question.