Correlation of MRI Edema and Clinical Outcomes Following Microfracture of Osteochondral Lesions of the Talus

Abstract

Background. Magnetic resonance imaging (MRI) is an accurate, noninvasive method used to assess healing of osteochondral lesions postoperatively. The purpose of the current study was to evaluate the presence of postoperative edema on MRI following osteochondral lesion of the talus (OLT) drilling and to correlate MRI findings with clinical outcome. Materials and Methods. A retrospective chart and MRI review was performed on all OLTs treated by arthroscopic drilling or microfracture. A musculoskeletal radiologist reviewed MRIs performed at a minimum of 9 months postoperatively and the amount of edema present at OLT drilling site was graded. MRI findings were correlated with clinical outcome. Results. A total of 29 patients with 30 OLTs were included. The average patient age at the time of surgery was 31.9 years (range = 13-52 years, SD = 11.87). The average time from arthroscopic drilling to MRI was 81.47 weeks (range 36-242 weeks, SD = 51.31). The intensity of edema was classified as none, mild, moderate, or severe based on MRI findings. Those patients with a moderate or severe edema intensity had inferior clinical outcomes (P = .011). Conclusion. The presence of edema on MRI following drilling of OLTs may be a valuable predictor of clinical outcome, with those patients with greater edema intensity having inferior clinical outcomes. Level of Evidence: Prognostic, Level II