Sex differences in osteochondral lesions of the talus: Lesion size reflects patients dimensions, whereas morphology differs between sexes.

Foot Ankle Surg · Jul 26 2026 · Recent

Gianakos AL, Pijnacker JHM, Sierevelt IN, Geurts EJ, Dahmen J, Hemke R, et al.

Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC, Location AMC, the Netherlands

Foot & Ankle Sports Medicine

SUMMARY — THE REDUCTIONIn 250 patients with talar osteochondral lesions, apparent sex differences in lesion size were explained by patient height rather than sex itself, though females had higher odds of crater-type lesion morphology.
Abstract, as published

BACKGROUND: This study evaluated sex differences in radiological lesion characteristics in patients with primary OLTs.

MATERIALS AND METHODS: This cross-sectional study included patients with symptomatic primary OLTs. Lesion size, location, and morphology were assessed using computed tomography. Sex differences were evaluated using univariable analyses and multivariable regression analyses adjusted for patient height and lesion etiology.

RESULTS: 94 female and 156 male patients were included. Male patients presented with larger OLTs across all dimensions compared with female patients (p ≤ 0.01). After adjustment for patient height, these differences were no longer statistically significant. Lesion morphology differed by sex, with females demonstrating higher odds of crater-type lesions (OR 2.5, 95%CI 1.1-5.9).

CONCLUSION: Sex differences in OLT size were attributable to talar dimensions rather than intrinsic sex-related factors. Females presented more frequently with crater lesions than males. Therefore, patient size and sex-specific morphological patterns should be considered in OLT treatment decision-making.

LEVEL OF EVIDENCE: Level III, cross-sectional cohort study.

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