Joint debridement and microfracture for treatment late-stage Freiberg-Kohler’s disease: Long-term follow-up study

Abstract Background Freiberg-Kohler’s disease is not a common disease and although various reports have been described since 1914, treatment methods are not completely established. The purpose of the present retrospective study was to evaluate the long-term outcomes following joint debridement and microfracture procedures for the treatment of Freiberg-Kohler’s disease. Methods Fifteen consecutive patients (16 feet) with Freiberg-Kohler’s disease (Smillie’s classification grade III–V) were operated between May 1996 to December 2011. All patients followed the same post-operative protocol. The objective and subjective evaluations were taken at the initial examination and at final follow-up. Results Mean follow-up was 11 years ±5.5 (range 4.2–19.7 years). The AOFAS score, VAS score and ROM of the MTP joint improved significantly after surgery (p value The AOFAS score improved from a preoperative value of 46.7 ± 15.5 points to 83.2 ± 9.4 points postoperative (p  Conclusions Our results suggest that joint debridement and microfracture procedure is an effective surgical treatment for late-stage Freiberg-Kohler’s disease with decrease of daily pain, improved ROM, and high patient satisfaction.