Value of magnetic resonance imaging in the follow-up of surgically treatedosteochondrosis dissecans of the talus

Aim: Our study was designed to evaluate the use of magnetic resonance imagi ng (MRI) in the follow-up of surgically treated osteochondrosis dissecans ( OCD) of the talus. Method: We investigated 16 patients (18 joints) with OCD of the talus, surgically treated in our department between 1990 and 1997. All of them had preoperative MRI scans of the affected ankle. The mean foll ow-up was 40 months (8-82). All patients were evaluated by clinical examina tion, plain radiography and MRI using a standard protocol. Results: The cli nical Bray score improved significantly from 58 preoperative to 82 postoper ative. Using a visual analogue scale we saw a significant reduction of the patients pain level post-op. In 72% of the patients the preoperative MRI wa s able to predict the accurate stage of the cartilage. Postoperative MRI sh owed no more lesion in 3, intact articular cartilage in 11, and disrupted c artilage in 4 joints. There was no correllation between clinical, plain rad iographical, and MRI findings postoperative. Conclusion: Arthroscopy remain s the golden standard in evaluating articular cartilage. Using our data, MR I is not the method of choice in the follow-up of surgically treated OCD le sions of the talus. Postoperative use of intravenous contrast media gave no additional information. Postoperative MRI should be reserved only for symp tomatic patients to gather additional information about the actual state of the OCD. Afterwards a prompt arthroscopy of the symptomatic ankle should b e performed.