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Background  The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents.    Methods  Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS],  n  = 8; arthroscopy + retrograde drilling,  n  = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting,  n  = 9; arthroscopy + BMS + retrograde drilling;  n  = 1; flake fixation,  n  = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus.  ‘Re-operation’ as the outcome measure was evaluated after a median follow-up of 42 months (range 6–117 months). Patients were further subdivided into groups A (re-operation,  n  = 7) and B (no re-operation,  n  = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables.    Results  Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13–61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS  n  = 2, arthroscopy + retrograde drilling  n  = 4, ACI + autologous bone grafting  n  = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A ( p  = 0.001).    Conclusions  We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.

Re-operation rate after surgical treatment of osteochondral lesions of the talus in paediatric and adolescent patients