Jumping Dot Sign: A New Radiological Sign Predicting Inferior Clinical Outcome and Higher Cyst Recurrence Following Bone Marrow Stimulation for Cystic Osteochondral Lesions of the Talus.

Background: Bone marrow stimulation (BMS) is the most commonly performed surgery for osteochondral lesion of the talus (OLT), but there is a risk of poor outcome when cysts recur. The indications of BMS in the presence of cystic OLT remain controversial. Purpose: To investigate whether a new "jumping dot (JD) sign," manifesting as speckle-like areas of elevated signals surrounding the subchondral bone cyst (SBC) on preoperative magnetic resonance imaging (MRI) against the background of bone marrow edema (BME), could be a predictor of clinical outcome and recurrence of SBCs following BMS and to further propose a more precise indication regarding BMS surgery for cystic OLT. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with cystic OLTs (<150 mm Results: A total of 117 patients were divided into the JD sign group (n = 41) and no JD sign group (n = 76), and no significant difference was found for the follow-up duration (48.04 ± 14.78 months vs 48.46 ± 15.38 months; Conclusion: The JD sign might be significantly associated with inferior clinical outcomes and higher SBC recurrence following BMS for cystic OLT. For those patients with the maximal vertical diameter of the cyst >5.4 mm and with JD signs, BMS may not be an appropriate option.