Combining arthroscopic microfracture, autologous bone grafting, and PRP injection for the treatment of Hepple IV-V stage osteochondral lesions of talus

Purpose: The purpose of this study is to evaluate the clinical and radiological outcomes of arthroscopic autologous cancellous bone grafting combined with PRP injection in patients with osteochondral lesions of talus (OLT). Methods: This study was conducted at Xuzhou Renci Hospital from January 2020 to June 2023, including patients diagnosed with Hepple stage IV or V OLT by magnetic resonance imaging (MRI). Surgical interventions included debridement and microfracture under arthroscopy, autologous cancellous bone grafting, and PRP injection. Preoperative and postoperative assessments were performed using the visual analogue scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, Kofoed score, and magnetic resonance observation of cartilage repair tissue (MOCART). Paired sample t-test was used for statistical analysis to compare data before and after surgery. Results: Twenty-one patients were enrolled, demonstrating significant postoperative improvements in VAS scores, AOFAS ankle-hindfoot scores, Kofoed scores (P < 0.05). Radiological examination showed good cartilage regeneration effects. No complications occurred in all patients, and no adverse reactions were observed at the donor knee site. Conclusion: Arthroscopic microfracture combined with autologous cancellous bone grafting and PRP injection is a promising technique for treating OLT, with good short-term outcomes and a high patient satisfaction rate, requiring further research for confirmation.