Robinson D E, Winson I G, Harries W J, Kelly A J
Southmead Hospital, Bristol, England.
J Bone Joint Surg Br. 2003 Sep;85(7):989-93. doi: 10.1302/0301-620x.85b7.13959.
We reviewed, retrospectively, 65 patients who had undergone arthroscopic treatment for osteochondral lesions of the talus. The 46 men and 19 women with a mean age at operation of 34.25 years, were followed up for a mean of 3.5 years. The medial aspect was affected in 45 patients and the lateral aspect in 20. All the lateral lesions and 35 (75%) of the medial lesions were traumatic in origin. Medial lesions presented later than lateral lesions (3 v 1.5 years) and had a much greater incidence of cystic change (46% v 8%). At follow-up, 34 patients had achieved a good result, and 17 and 14 fair and poor results, respectively. Of the 14 poor results, 13 involved medial lesions. Cystic lesions had a poor outcome in 53% of patients. Excision and curettage led to better results than excision and drilling of the base. Further arthroscopic surgery for patients with a poor result was disappointing. There was no association between outcome and the patient's age.
我们回顾性研究了65例接受距骨骨软骨损伤关节镜治疗的患者。其中46例男性和19例女性，手术时平均年龄为34.25岁，平均随访3.5年。45例患者内侧受累，20例外侧受累。所有外侧损伤及35例（75%）内侧损伤均为创伤性起源。内侧损伤比外侧损伤出现时间晚（3年对1.5年），且囊性变发生率更高（46%对8%）。随访时，34例患者效果良好，17例效果尚可，14例效果不佳。在14例效果不佳的患者中，13例为内侧损伤。53%的囊性病变患者预后较差。切除及刮除术的效果优于切除并钻孔术。对效果不佳的患者进行进一步关节镜手术效果令人失望。预后与患者年龄无关。
