Subchondroplasty of the Ankle and Hindfoot for Treatment of Osteochondral Lesions and Stress Fractures: Initial Imaging Experience

Geoffrey D. McWilliams, Lawrence Yao, Luke B. Simonet, Connor W. Haysbert, Eric Giza, Christopher Kreulen, Robert D Boutin

Research output: Contribution to journalArticle

Abstract

Objective:To describe the imaging findings of patients treated with subchondroplasty (SCP) of the ankle and hindfoot. Materials and Methods: Eighteen patients (10 men, 8 women; age mean 43.1 years [range 20.1-67.7 years]) underwent ankle and hindfoot SCP at a single center over a 14-month period. Imaging data were reviewed retrospectively by 2 radiologists by consensus interpretation, including preoperative radiography (18), computed tomography (CT) (11), and magnetic resonance imaging (MRI) (13) and postoperative radiography (10), CT (4), and MRI (6). Follow-up imaging was acquired 1 month to 1.6 years following SCP. Results: Indications for SCP included symptomatic bone marrow lesions (BMLs) secondary to an osteochondral lesion (OCL) (16/18) or stress fracture (2/18). While focal radiodensity related to the SCP procedure was retrospectively identifiable on postoperative radiography in all except 1 case (10/11), postprocedural findings were not described by the interpreting radiologist in 6/11 cases. On CT, the average injected synthetic calcium phosphate (CaP) volume was 1.15 cm3 (SD = 0.33 cm3); mean CT attenuation of the injectate was 1220 HU (range 1058-1465 HU). In all patients who had pre- and postoperative MRI (5/18), BML size decreased on follow-up MRI. Extra-osseous extrusion of CaP was not seen on postoperative radiography, CT, or MRI. Conclusion: Physicians should be aware of the expanding preoperative indications and postoperative imaging findings of SCP, which is being performed with increasing frequency in the ankle and hindfoot. Levels of Evidence: Diagnostic, Level III: Retrospective cohort study.

Original languageEnglish (US)
JournalFoot and Ankle Specialist
DOIs
StateAccepted/In press - Jan 1 2019

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Keywords

  • ankle
  • arthritis and joint disease
  • bone
  • bone healing
  • comorbid conditions
  • diagnostic and therapeutic techniques
  • heel
  • magnetic resonance imaging (MRI)
  • MRI diagnoses
  • orthobiologics
  • rearfoot

ASJC Scopus subject areas

  • Surgery
  • Podiatry
  • Orthopedics and Sports Medicine

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