Effects of Pulsed ElectroMagnetic Fields on return to sports after arthroscopic debridement and microfracture of osteochondral talar defects

BACKGROUND

Osteochondral defects (OCDs) of the talus usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracture. This treatment has an 85% overall success rate and a 76% satisfactory outcome at the long term. However, it can take up to one year to obtain improvement of clinical symptoms. Various possibilities have been suggested in order to improve the recovery process after debridement and microfracture. A potential solution to obtain this goal is the application of pulsed electromagnetic fields (PEMF), which stimulates the repair process of bone and cartilage.

HYPOTHESIS

The use of PEMF after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports, and an increased number of patients that resume sports.

DESIGN

This study is a randomized, double-blind, placebo-controlled, multicenter trial, with a one year follow-up. Sixty-eight patients will be randomized to either PEMF or placebo after arthroscopic treatment of an OCD of the talus. The primary outcomes are the number of patients that resume sports and time to resumption of sports. Functional outcomes will be assessed with questionnaires (American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Foot and Ankle Outcome Score, EuroQol, and numeric rating scales for pain and satisfaction) at multiple time points up to 1 year follow-up. To assess bone repair, computed tomography (CT) scans will be obtained at 2 weeks and 1 year postoperatively.