OBJECTIVE: To compare arthroscopic microfracture efficacy between talar osteochondral lesion (OLT) patients with and without monosodium urate (MSU) deposition, and identify poor prognosis risk factors.
METHODS: Sixty-one OLT patients were stratified into MSU (n = 26) and non-MSU (n = 35) groups, followed ≥ 24 months. Outcomes were assessed using VAS, AOFAS and MOCART scores. Multivariate logistic regression was performed.
RESULTS: MSU group had higher preoperative uric acid (516.37 ± 63.36 vs 342.57 ± 60.83 μmol/L, P < 0.001), higher postoperative VAS (1.43 ± 0.77 vs 0.83 ± 0.42, P = 0.001), lower AOFAS (81.09 ± 8.26 vs 86.44 ± 9.65, P = 0.027) and inferior MOCART scores (lower complete defect filling, P = 0.042). MSU deposition (OR=1.988, P = 0.002) and large defects (OR=2.234, P = 0.001) were independent risk factors. Complication rate was higher in MSU group (30.77% vs 5.71%, P = 0.032).
CONCLUSION: MSU crystal deposition significantly impairs clinical outcomes and cartilage repair after OLT microfracture, representing an independent adverse prognostic factor.
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