Juvenile osteochondral lesions of the talus: need for surgery and surgical treatment results

Aims: Juvenile osteochondral lesions of the talus (JOLTs) are complex lesions affecting the articular cartilage and subchondral bone of the talus.This study aimed to assess the need for surgical intervention following conservative management of JOLTs and to evaluate the early outcomes after surgery.Methods: This retrospective study identified patients aged 18 years or younger who were surgically treated for JOLTs at our institution from 2018 to 2021.The surgical treatment indication was conservative treatment failure.Patients were followed up for 2 years using the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score. Results:The study included 12 patients with a median age of 15 (10-17) years.All lesions were stage 2-3 at initial presentation.Conservative treatment failed in 8 of 12 patients (67%), and these patients underwent surgical treatment.The median pre-operative and follow-up AOFAS scores were 39.5 (21-75) and 88 (51-100), respectively.The median pre-operative and follow-up VAS scores were 8 (5-9) and 2 (0-9), respectively. Conclusions:The success rate of conservative treatment of JOLTs was lower than expected.This study showed early success of surgical treatment of JOLTs.