Medial Talus Osteokondral Lezyonlarında Mikrofraktür ve Mozaikoplastinin Karşılaştırmalı Klinik ve Fonksiyonel Sonuçları

Year 2024, , 306 - 314, 30.09.2024

Sönmez Sağlam , Mehmet Arıcan , Zekeriya Okan Karaduman , Mücahid Osman Yücel , Raşit Emin Dalaslan

https://doi.org/10.31832/smj.1519991

Abstract

Amaç: Bu çalışma, medial talus osteokondral lezyonlarının (OCL'ler) tedavisinde iki cerrahi müdahale, mikrofraktür ve mozaikoplastinin erken klinik ve fonksiyonel sonuçlarını karşılaştırmayı amaçlamaktadır.

Yöntem ve Gereçler: Bu retrospektif çalışma, Ocak 2016'dan Ocak 2022'ye kadar XXX Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı'nda tedavi edilen hastaları içermektedir. Hastalar, mikrofraktür uygulananlar (Grup 1, n=20) ve mozaikoplasti uygulananlar (Grup 2, n=17) olarak iki gruba ayrılmıştır. Preoperatif ve postoperatif takip verileri başlangıçta, 6. ayda ve 12. ayda görsel analog skala (VAS) ve Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) skorlarını içermektedir. İstatistiksel analiz NCSS yazılımı kullanılarak yapılmış olup, anlamlılık seviyesi p<0,05 olarak belirlenmiştir.

Bulgular: Mikrofraktür grubunun ortalama yaşı 37,9±12,5 yıl, mozaikoplasti grubunun ise 38±12,46 yıl idi (p=0,981). Her iki grup da başlangıçtan 6. ve 12. aylara kadar VAS skorlarında anlamlı iyileşme göstermiş olup, mozaikoplasti grubu ağrı azalmasında daha üstün bulunmuştur (p<0,001). AOFAS skorları da her iki grupta anlamlı olarak iyileşmiş olup, mozaikoplasti grubunun 12. ayda daha iyi fonksiyonel sonuçlar gösterdiği tespit edilmiştir (p=0,069).

Sonuç: Mikrofraktür ve mozaikoplasti, medial talus OCL'lerin tedavisinde erken dönemde ağrının azaltılmasında ve klinik durumda etkilidir.

Keywords

Talus, osteokondral lezyonlar, mikrofraktür, mozaikoplasti

Comparative Clinical and Functional Results of Microfracture and Mosaicoplasty in Medial Talus Osteochondral Lesions

Abstract

Introduction: This study aims to compare the early clinical and functional outcomes of two surgical interventions, microfracture and mosaicoplasty, in the treatment of medial talus osteochondral lesions (OCLs).
Materials and Methods: This retrospective study included patients treated in the Department of Orthopaedics and Traumatology, Faculty of Medicine, Düzce University from January 2016 to January 2022. Patients were divided into two groups as those who underwent arthroscopic microfracture (Group 1, n=20) and those who underwent mosaicoplasty (Group 2, n=17). Preoperative and postoperative follow-up data were evaluated with visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores at baseline, 6 months and 12 months.
Results: The mean age was 37.9±12.5 years in the microfracture group and 38±12.46 years in the mosaicoplasty group (p=0.981). Both groups showed significant improvement in VAS scores from baseline to the 6th and 12th months, and pain reduction was more significant in the mosaicoplasty group (p<0.001). AOFAS scores improved significantly in both groups and the mosaicoplasty group had better functional results at 12 months (p=0.069).
Conclusions: Microfracture and mosaicoplasty are effective in the treatment of medial talus OCLs to reduce pain and improve clinical status in the early period.

Keywords

Talus, Osteochondral lesions, Microfracture, Mosaicplasty

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