2025 ISAKOS Biennial Congress ePoster
Non-Primary Arthroscopic Bone Marrow Stimulation For Osteochondral Lesions Of The Talus Yields Limited Improvements In Patient Reported Outcomes Compared To Primary Cases: A Prospective 2-Year Follow-Up Study
Quinten G.H. Rikken, MD, Amsterdam NETHERLANDS
Jari Dahmen, MD, BSc, Amsterdam NETHERLANDS
Julian Hollander, BSc, Amsterdam NETHERLANDS
Jason Steman , MD, Alkmaar NETHERLANDS
Sjoerd A.S. Stufkens, MD, PhD, Amsterdam NETHERLANDS
Gino M. M. J. Kerkhoffs, MD, PhD, Prof., Amsterdam NETHERLANDS
Amsterdam UMC, Amsterdam, NETHERLANDS
FDA Status Not Applicable
Summary
The most important finding of this study is that non-primary BMS for OLT yielded a significant improvement in patient-reported outcomes compared to baseline, but an inferior improvement compared to primary BMS up to 2-year follow-up. These results show that, although non-primary BMS is a viable option, its clinical benefit may be less than in primary OLT cases. These outcomes are crucial for patie
ePosters will be available shortly before Congress
Abstract
Purpose
to prospectively assess the patient-reported clinical outcomes of non-primary bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLT) and to compare these with primary cases at 2-year follow-up. The secondary aims were to assess the association of baseline factors with outcomes and the occurrence of adverse events.
Methods
Patients who underwent arthroscopic BMS were prospectively assessed and included up-to 2-year follow-up and were grouped according to non-primary (i.e., failed previous OLT surgery) or primary BMS. Patient-reported outcomes were collected at baseline and 2-years follow-up and included the Numeric Rating Scale (NRS) for pain and the foot and ankle outcome score (FAOS) questionnaires. The primary outcome was the improvement NRS during walking. Adverse events concerned reoperations and complications during the study period. A Wilson score method (without continuity correction) was used to calculate 95% confidence intervals (95%-CI) for dichotomous outcomes.
Results
The primary outcome, the NRS during walking, significantly improved from baseline to 2-years postoperatively in the primary (median 5 [IQR: 3 – 7] to 0.5 [IQR: 0 - 2], P= <0.01) and the non-primary (median 6 [IQR: 3 – 8] to 4 [IQR: 1 – 6], P= <0.01) group. The improvement of the primary outcome was significantly higher in the primary group (median 3 [IQR: 1 – 5] out of 10) compared to the non-primary group (median 1 [IQR: 1 – 3] out of 10), P= 0.02. No significant between-group differences were observed in the improvement of the NRS in rest, running, or stairclimbing, as well as the FAOS sub-scales.
In total, 2 revision procedures (non-primary group: 11% [95-CI: 13% - 33%] versus 0% primary group, P=0.2) occurred. One case (non-primary group: 5% [13% - 26%] versus primary group: 0%, P= 0.4) had a complication.
Conclusion
Non-primary BMS for OLT yields a significant improvement in patient-reported outcomes compared to baseline, but an inferior improvement compared to primary BMS up to 2-year follow-up. These results show that, although non-primary BMS is a viable option, its clinical benefit may be less than in primary OLT cases. These outcomes are crucial for patient selection and shared-decision making.