Abstract
Category:
Ankle
Introduction/Purpose:
The primary aim of the present study is to assess the clinical success rate of fixation for osteochondral lesions of the talus (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). 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. The pooled clinical success rate was 92% [95%-CI: 87% – 95%]. The pooled union rate was 91% [95%-CI: 87% - 94%]. A sub-analysis found superior success rate for patients treated with bone-peg (98% [95%-CI: 89 – 100] compared to non-metal screw and pin (84% [95%-CI: 68 – 93]), P=0.03. 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 always consider fixation.
