Magnetic Resonance Imaging and Outcomes of Osteochondral Lesions of the Talus Associated With Ankle Fractures

Abstract

Background: Osteochondral lesions of the talus (OCLTs) secondary to ankle fractures have previously been reported in the literature. However, no study has evaluated OCLTs using magnetic resonance imaging (MRI) following ankle fracture treatment. The purpose of our study was to investigate accompanying OCLTs in patients with an ankle fracture and evaluate its relationship with the clinical outcomes. Methods: Fifty-six patients with ankle fractures who were treated with either a nonoperative or operative method at our center between June 2016 and February 2017 were included in this prospective comparative study (37 men and 19 women; mean age, 44.6 ± 13 years; range, 20-65 years). The mean American Orthopaedic Foot & Ankle Society (AOFAS) scores were used to evaluate the clinical results in all patients in the second month and second year. The second-month ankle MR images were evaluated for OCLTs in all patients. Thirty patients were treated operatively and 26 nonoperatively. Results: Accompanying OCLTs were detected in 19 of 56 patients (34%). Our results showed no statistically significant association between OCLT and fracture type, as well as the treatment type. In the second postoperative month, the mean AOFAS scores were 87.2 ± 10.8 and 77.6 ± 12.0 in patients with and without OCLTs, respectively ( P = .005). In the second postoperative year, the mean AOFAS scores were 81.3 ± 6.8 and 86.2 ± 8.4 in patients with and without OCLTs, respectively ( P = .031). The mean AOFAS score significantly decreased in the OCLT group in the second-year control, whereas a significant increase was observed in patients without OCLTs ( P = .026 and P < .001, respectively). Conclusion: According to our results, the accompanying OCLTs were found in one-third of patients treated for ankle fractures. We observed a significant correlation between OCLT presence and the AOFAS score. According to the AOFAS score, OCLTs statistically significantly affected clinical results at 2 years. Level of Evidence: Level II, prospective comparative study.