engleski

Postsurgical MRI characteristics of talar osteochondral lesions in young patients

AIM: To assess magnetic resonance imaging (MRI) outcomes following arthroscopic microfracture (AM) of osteochondral lesions of the talus (OLT) in children before skeletal maturity. PATIENTS AND METHODS: Eleven patients with OLT treated by AM before skeletal maturity were included in the study (6 boys and 5 girls ; median age 15, age range 13-16, at the time of AM). In all patients MRI was performed using 1.5 T machine. Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system was used to evaluate MRI findings: the degree of defect repair and filling of the defect ; the surface, structure and signal intensity of the repair tissue ; the integration to border zone ; the appearance of subchondral lamina and bone ; the presence of adhesions and effusion were analyzed. The maximum score achievable was 100. RESULTS: The median follow-up was 5.6 years (range, 3.8 to 13.6). MRI showed some degree of defect repair in all patients. The hypertrophy with intact surface of repair tissue was found in 9 (81.8%) patients and complete integration to border zone in 8 (72.7%) patients. The structure of the repair tissue was inhomogeneous in all patients and the signal intensity was nearly normal in all but one patient. Subchondral bone marrow edema was present in 7 (63.6%) patients and 4 of them complained of moderate pain. The median MOCART score was 65 (range, 10 to 75). In 10 patients MOCART score was similar (range, 50 to 75) and one patient had a poor result with the score of 10 points (presence of adhesions and effusion). CONCLUSION: MRI is a method of choice for follow-up in patients with OLT after AM. Mid-term results of MRI showed mostly good outcomes. Bone marrow edema didn't correlate with pain, it was present also in asymptomatic patients. Without regards to poor MOCART score in one patient, AM seems to be an optimal surgical treatment for OLT in skeletally immature children.

MRI ; osteochondral ; lesion ; talus

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