Gundersen Lutheran Medical Foundation, La Crosse, Wisconsin 54601, USA.
Arthroscopy. 2012 Dec;28(12):1902-7. doi: 10.1016/j.arthro.2012.04.055. Epub 2012 Aug 11.
The purpose of this systematic review was to determine patient outcomes after arthroscopic debridement and microfracture for osteochondral lesions (OCLs) of the talar dome.
Infotrieve-PubMed/MEDLINE and Google Scholar were systematically searched for the following terms: microfracture AND ankle OR talus. In addition, we hand-searched common American and European orthopaedic and podiatric surgical journals for relevant manuscripts. Articles considered for inclusion were published in peer-reviewed journals, used the American Orthopaedic Foot & Ankle Society hindfoot scoring system for outcome measurement, and involved arthroscopic debridement and microfracture for OCL of the talar dome.
We identified 29 potentially relevant publications, of which 7 met our inclusion criteria. A total of 295 patients (299 ankles) were included in this study. The weighted mean postoperative American Orthopaedic Foot & Ankle Society hindfoot score was 86.8 points, translating to good to excellent outcomes in 80.2% of patients.
Many techniques exist for the treatment of OCLs of the talar dome. Good to excellent results can be consistently reached in greater than 80% of patients with arthroscopic debridement and microfracture. However, additional prospective trials should be undertaken to determine differences in outcome between techniques, size and location of the OCL, and other patient quality factors, such as cost and time to return to work.
Level IV, systematic review of Level II, III, and IV studies.
本系统评价的目的是确定距骨穹窿骨软骨病变（OCL）关节镜下清创和微骨折术后的患者结局。
通过 Infotrieve-PubMed/MEDLINE 和 Google Scholar 系统搜索以下术语：微骨折术和踝关节或距骨。此外，我们还对手册搜索了常见的美国和欧洲骨科和足病外科杂志，以获取相关文献。考虑纳入的文章均发表在同行评议的期刊上，使用美国矫形足踝协会后足评分系统进行结局测量，并涉及关节镜下清创和微骨折术治疗距骨穹窿 OCL。
我们确定了 29 篇可能相关的文献，其中 7 篇符合纳入标准。本研究共纳入 295 例患者（299 例踝关节）。加权平均术后美国矫形足踝协会后足评分 86.8 分，80.2%的患者结局为良好至优秀。
治疗距骨穹窿 OCL 的技术有很多。关节镜下清创和微骨折术可使 80%以上的患者获得良好至优秀的结果。然而，应进行更多的前瞻性试验，以确定不同技术、OCL 的大小和位置以及其他患者质量因素（如成本和重返工作时间）之间的结局差异。
四级，对二级、三级和四级研究的系统评价。
