Long-Term Clinical Results of Arthroscopic Lift-Drill-Fill and Fixation (LDFF) Treatment for Osteochondral Lesions of the Talus

Abstract

Category: Ankle; Arthroscopy Introduction/Purpose: The purpose of this study was to describe the long-term (> 5 years) clinical results of a novel arthroscopic fixation technique for osteochondral lesions of the talus (OLT), named the Lift, Drill, Fill and Fix (LDFF) technique. Methods: 18 ankles (17 patients) underwent an arthroscopic LDFF procedure for a primary OLT. The mean follow-up was 6.8 years (range: 68 - 96 months). Pre- and postoperative clinical assessment was prospectively performed by measuring the Numeric Rating Scale (NRS) of pain at rest, during walking, and when running. Additionally, the Foot and Ankle Outcome Score (FAOS) including its subscores of pain, symptoms, activities of daily living, sports, and quality. Additionally, the Short Form-36 (SF-36) was assessed. Results: The mean NRS during running significantly improved from 7.8 pre-operatively to 3.7 post-operatively (p = 0.006), the NRS during walking from 5.7 to 1.5 (p < 0.001), and the NRS in rest from 2.3 to 1.0 (p = 0.015). The median FAOS at final follow- up was 80 for pain, 57 for other symptoms, 90 for activities of daily living, 70 for sport, and 55 for quality of life. A pre- and post- operative score comparison was available for fifteen patients, and improved significantly in most subscores. The SF-36 physical component scale significantly improved from 42.9 pre-operatively to 50.1 post-operatively. Conclusion: Arthroscopic LDFF of fixable primary OLTs results in excellent pain reduction and improvement of functional outcomes, with sustained results at long-term follow-up. These results indicate surgeons should consider fixation for a fixable OLT.