Association of Factors Related to the Size and Hepple Classification of Medial Osteochondral Lesions of the Talus

Background: Few studies have analyzed the association of factors contributing to the morphologic changes of medial osteochondral lesions of the talus (OLTs). Methods: Two hundred eighty consecutive patients who underwent surgery for OLTs from January 2010 to December 2022 were enrolled. The potential association of factors were age, gender, side of injury, duration of symptoms, body mass index, history of ankle sprain, chronic lateral ankle instability (CLAI), and ankle varus. Multivariate logistic regression analysis was performed to evaluate the association between these factors and both the size and Hepple classification of OLTs. Results: Size of OLTs was associated with age 40-60 years (OR 2.14, 95% CI 1.08-4.25; P = .029), age >60 years (OR 3.78, 95% CI 1.61-8.89; P = .002), duration of symptom 1-3 years (OR 2.06, 95% CI 1.03-4.15; P = .042), and duration of symptoms ≥3 years (OR 2.27, 95% CI 1.09-4.71; P = .028). CLAI was negatively correlated with the size of OLTs (OR 0.30, 95% CI 0.17-0.54; P < .001). Age >60 years was associated with Hepple V classification (OR 3.65, 95% CI 1.50-8.89; P = .004). Conclusion: In our cohort we found older age positively correlated with Hepple V classification. Increasing age and duration of symptom are positively associated with increasing size of medial OLTs, whereas CLAI was negatively correlated with the lesion size.