Treatment of the unstable ankle with an osteochondral lesion: results and long-term follow-up.

BACKGROUND: Few reports have studied the treatment of osteochondral lesions of the talus (OLTs) in the setting of lateral ankle instability.

HYPOTHESIS: Arthroscopic treatment of an OLT and lateral ankle stabilization in the same sitting is safe and leads to reliable improvement of symptoms.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: Of 37 patients who underwent concomitant treatment of an OLT and lateral ankle stabilization, 31 (84%) were evaluated at a mean of 7.3 years postoperatively. Patients were evaluated by physical examination, the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale, the modified Weber Scale, the Single Assessment Numeric Evaluation, the Berndt and Harty Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey.

RESULTS: The average postoperative ankle-hindfoot score was 89, the mean modified Weber score was 85, and the mean Single Assessment Numeric Evaluation was 86. In sum, 74% of patients had a good result on the Berndt and Harty Scale, 23% had a fair result, and 3% had a poor result. Of the short-form survey, the mean physical function score was 86.5, and the mean summary physical component score was 52.3. For the 13 patients for whom prospective ankle-hindfoot scores were available, a statistically significant improvement was seen, from 75 points preoperatively to 91 points postoperatively (P <.001).

CONCLUSION: Simultaneous arthroscopic treatment of an OLT and open lateral ankle stabilization is a safe and effective procedure. The presence of an osteochondral lesion had a negative effect on the overall result when compared to that of patients who underwent lateral ankle stabilization as an isolated procedure.