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Osteochondritis dissecans lesions of the talus in adolescent athletes: Outcomes and management of arthroscopic surgery
Journal article   Open access   Peer reviewed

Osteochondritis dissecans lesions of the talus in adolescent athletes: Outcomes and management of arthroscopic surgery

Tommy Pan, Samantha N. Olson, Brianne M. Giuffrida, William Pinamont and William L. Hennrikus
Journal of Orthopaedic Reports, v 4(4), 100478
01 Dec 2025
DOI: https://doi.org/10.1016/j.jorep.2024.100478
url
https://doi.org/10.1016/j.jorep.2024.100478View
Published, Version of Record (VoR) Open

Abstract

Arthroscopy Foot and ankle Osteochondral lesions Talus Pediatrics
Osteochondritis dissecans (OCD) causes joint pain in children. Treatment consists of conservative management or surgery depending on injury staging; however, duration of conservative treatment, surgical modality and postoperative protocols are not well-established. This study aims to evaluate the outcomes of symptomatic OCD of the talus treated by arthroscopic-assisted management and drilling of the talar bed with or without fixation. A retrospective review was performed on 12 adolescents with symptomatic OCD. Data extracted included: age, gender, body mass index, sporting activity, mechanism of injury (MOI), operative modality and duration of follow-up. AOFAS Ankle-Hindfoot, Alexander/Lichtman, and Berndt and Harty outcome scores were used. Twelve patients were studied (9 girls, 3 boys). The average age was 14.2 years. MOI included: sprain (66.7 %), sporting activity (25 %) and trauma (8.3 %). Berndt and Hardy classification included: Stage 3 (4) and Stage 4 (8). All failed conservative treatment for at least 6 months. Surgery included: arthroscopic-assisted arthrotomy and drilling of the talar bed with or without fragment fixation. Duration of follow-up averaged 23.1 months (range, 3–58 months). At final follow-up, the AOFAS score averaged 96.0. Alexander/Lichtman and Berndt and Hardy scores were all excellent. In the pediatric population with OCD lesions of the talus who have failed an initial 6-month conservative trial prior to operative management, arthroscopy can help assess for instability prior to definitive treatment. Arthroscopic-assisted drilling to stimulate healing and/or open reduction internal fixation of the fragment can result in excellent outcomes and return to sporting activity.

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