2025 ISAKOS Biennial Congress ePoster
Fix While You Can: A Systematic Review on Outcomes of Fixation for Osteochondral Lesions of the Talus
Quinten G.H. Rikken, MD, Amsterdam NETHERLANDS
Jari Dahmen, MD, BSc, Amsterdam NETHERLANDS
Sjoerd A.S. Stufkens, MD, PhD, Amsterdam NETHERLANDS
Tomoyuki Nakasa, MD, PhD, Hiroshima City JAPAN
Gino M. M. J. Kerkhoffs, MD, PhD, Prof., Amsterdam NETHERLANDS
Amsterdam UMC, Amsterdam, NETHERLANDS
FDA Status Not Applicable
Summary
Fixation for osteochondral lesions of the talus leads to successful clinical outcomes in 9 out of 10 patients. Moreover, fragment union is achieved in 9 out of 10 cases, with a low reported complication rate. These findings show that when a symptomatic OLT is fixable physicians should consider fixation.
ePosters will be available shortly before Congress
Abstract
Introduction
Osteochondral lesions of the talus (OLT) with an osteochondral fragment are amendable for fixation. Fixation aims to stabilize the osteochondral fragment while retaining the native cartilage. Though fixation for OLT is a promising treatment, no systematic overview of the literature on its efficacy and safety exists. The primary aim of the present study is to assess the clinical success rate of fixation for OLT. The secondary outcomes concern the union rate and adverse events.
Methods
A systematic literature search of PubMed, Embase (Ovid), and Cochrane Library was performed up to December 2023. The primary outcome was the pooled clinical success rate following fixation with 95% confidence interval (95%-CI). Success was predefined based on cut-off values for commonly used patient- or physician-reported outcome measures. Secondary outcomes concerned the union rate, complication rate, and revision rate.
Results
A total of 10 studies with 241 ankles were included at a mean follow-up of 40 months. 88% of lesions were chronic in nature, and 12% acute. The pooled clinical success rate was 91% [95%-CI: 81 – 96]. The pooled union rate was 91% [95%-CI: 87% - 94%]. The addition of biological adjuncts in the form of autologous bone-grafting did not show a superior success rate. The pooled complication and revision rate were 1% [95%-CI: 0 - 4] and 6% [95%-CI: 0 - 4], respectively.
Conclusion
Fixation for osteochondral lesions of the talus leads to successful clinical outcomes in 9 out of 10 patients. Moreover, fragment union is achieved in 9 out of 10 cases, with a low reported complication rate. These findings show that when a symptomatic OLT is fixable physicians should consider fixation.