Description of patient (type of occupation, indication of age, intensity of sport):
29 year old non athlete females
History and previous treatment:
8 months of pain in right ankle. No history of known trauma. Steroid injection with temporary relief. Arthoscopic debridement and microfractures right ankle 5 months ago
Still in pain, edema and limitation in activities of daily living
Limited ROM. Normal lower extremity alingnment. Ankle edema right foot. Subtalar, Chopart and forefoot normal
Additional investigation (CT/MRI)
[Picture 1, 2 + 3]
29 year old female. Arthroscopic debridement and microfractures right talus five moths ago. Ongoing symptoms with pain, limitation on daily living activities
Question(s) to this case:
Next treatment options: OATS procedure or repaet debridement and microfracture??? In Colombia fresh frozen osteochondral graft is not an option.
Make a standing AP X-Ray and look at the alignment. Not only radiological alignment but also clinical alignment.
Consider a lateralising calcaneal osteotomy!
Of course OATS is an option. A second debridement has a 70 % chance. An OATS 85-90%