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Evidence summaries

Treatment Strategies for Osteochondral Defects of Talus

Operative treatments may be more effective than non-operative or excision alone for osteochondral defects of the talus. Level of evidence: "C"

A systematic review 1 included 32 studies (no RCTs) with a total of 701 subjects. The average success rate of non-operative treatment was 45%. When the different surgical procedures were compared, the average highest success rate was reached with excision plus curettage plus drilling (ECD) (85%), followed by excision plus curettage (EC) (78%) and excision alone (38%).

When the different surgical procedures were compared within the studies, the results showed that the outcome of ECD was superior to excision alone. No data were available to compare ECD with EC in the same study. The results of cancellous bone grafting, osteochondral transplantation and fixation were encouraging, but there were too few excision plus curettage plus drilling studies available to draw any firm conclusions.

    References

    • Tol JL, Struijs PA, Bossuyt PM, Verhagen RA, van Dijk CN. Treatment strategies in osteochondral defects of the talar dome: a systematic review. Foot Ankle Int 2000 Feb;21(2):119-26. [PubMed]

Primary/Secondary Keywords