Retrograde Drilling for Osteochondral Lesions of the Talar Dome

BackgroundFor the treatment of osteochondral lesions of the talar dome without detachment of the cartilage, there is little information on whether transmalleolar drilling or retrograde drilling is more effective in terms of clinical and morphologic evaluations.HypothesisRetrograde drilling may be more effective than transmalleolar drilling for lesions without cartilage detachment.Study DesignCase control study; Level of evidence, 3.MethodsSubjects were 30 patients with lesions on 1 foot of grade 0 or I, determined according to a modified Pritsch classification system. Nineteen patients underwent transmalleolar drilling (TMD group), and 11 patients underwent retrograde drilling (RD group). Ankle arthroscopy was performed 1 year postoperatively to evaluate cartilage conditions.ResultsArthroscopic findings revealed that in the TMD group, 11 lesions (57.9%) were unchanged (grade I), and 8 lesions (42.1%) had deteriorated from grade 0 to I; in the RD group, 3 lesions (27.2%) had improved from grade I to 0, and...