The Impact of Weight on Arthroscopic Osteochondral Talar Reconstruction

Background: The purpose of the study was to assess the functional and radiologic outcomes after AT-AMIC (arthroscopic talus autologous matrix–induced chondrogenesis) in 2 weight groups of patients with osteochondral lesions of the talus (OLTs): patients with BMI <25 (Healthy Weight Group [HG]) and with BMI ≥25 (Overweight Group [OG]). Methods: Thirty-seven patients were evaluated. HG was composed of 21 patients (BMI = 21.90 ± 1.94), whereas OG consisted of 16 patients (BMI = 27.41 ± 1.98). All patients were treated with AT-AMIC repair for OLTs. Magnetic resonance imaging (MRI), computed tomography (CT), Visual Analgoue Scale (VAS) for pain, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle and Hindfoot score and Short-Form Health Survey (SF-12) were administered preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively. Results: In both groups, we found a significant difference for clinical and radiologic parameters with analysis of variance for repeated measures through 4 time points (P <.001). In HG, AOFAS increased at every follow-up (P <.05), whereas in OG, AOFAS improved only between T2 and T3 (P =.0104). In OG we found a significant difference comparing CT and MRI at each follow-up; in HG this difference was found only at T0 (P <.0001) and T1 (P =.0492). Finally, OG presented a significantly larger lesion measured with MRI at T0 (P =.033). Conclusions: OLTs in overweight patients were characterized by a larger preoperative size. At final follow-up, both groups showed a significant clinical improvement. AT-AMIC can be considered a safe and reliable procedure, regardless of weight, with a significant improvement also in quality of life. Level of Evidence: Level III, comparative study.