Wiewiorski Martin, Werner Lorenzo, Paul Jochen, Anderson Andrew E, Barg Alexej, Valderrabano Victor
Orthopaedic and Trauma Department, Kantonsspital Winterthur, Winterthur, Switzerland
Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
Am J Sports Med. 2016 Oct;44(10):2651-2658. doi: 10.1177/0363546516659643. Epub 2016 Sep 1.
For the treatment of osteochondral lesions of the talus (OCLTs), autologous matrix-induced chondrogenesis (AMIC) is a safe 1-step procedure with good clinical and radiological results. However, data regarding postoperative sports activity after AMIC are limited.
To identify significant factors influencing the rate of postoperative sports and recreational activities.
Case series; Level of evidence, 4.
The sports and recreational activities of 60 patients (mean age, 34.9 ± 11.5 years) undergoing the AMIC procedure were retrospectively analyzed at a mean of 46.9 ± 17.8 months (range, 24.5-87.0 months) postoperatively. The visual analog scale (VAS) for pain score, Tegner activity scale score, activity rating scale (ARS) score, and satisfaction with surgery outcomes were assessed.
Corrective calcaneal osteotomy was performed in 38 of 60 (63.3%) patients. Ligament repair was performed in 41 of 60 (68.3%) patients. The mean VAS score improved significantly from 6.9 ± 1.6 points (range, 5-10 points) preoperatively to 2.3 ± 1.9 points (range, 0-6 points) at latest follow-up (P < .001). No significant change in the mean Tegner activity scale score (3.3 ± 2.0 preoperatively to 3.4 ± 2.2 postoperatively; P = .526) and the mean ARS score (2.6 ± 4.3 preoperatively to 2.3 ± 3.4 postoperatively; P = .874) was noted. The percentage of patients involved in sports activity before the onset of symptoms became significantly lower at the time of surgery (from 95.0% to 53.3%; P < .001); no significant difference was noted postoperatively (from 53.3% to 58.3%; P = .663). No significant difference of the weekly sports frequency and the duration of sports activity was found postoperatively.
Patients undergoing AMIC repair of an OCLT participate at a similar low postoperative sports and recreational activity level compared with the preoperative level.
对于距骨骨软骨损伤（OCLTs）的治疗，自体基质诱导软骨形成术（AMIC）是一种安全的单步手术，具有良好的临床和影像学效果。然而，关于AMIC术后体育活动的数据有限。
确定影响术后体育和娱乐活动率的重要因素。
病例系列；证据等级，4级。
对60例行AMIC手术的患者（平均年龄34.9±11.5岁）进行回顾性分析，术后平均随访46.9±17.8个月（范围24.5 - 87.0个月）。评估疼痛评分的视觉模拟量表（VAS）、Tegner活动量表评分、活动评级量表（ARS）评分以及对手术结果的满意度。
60例患者中有38例（63.3%）进行了跟骨截骨矫正术。60例患者中有41例（68.3%）进行了韧带修复。平均VAS评分从术前的6.9±1.6分（范围5 - 10分）显著改善至末次随访时的2.3±1.9分（范围0 - 6分）（P <.001）。Tegner活动量表平均评分（术前3.3±2.0至术后3.4±2.2；P =.526）和ARS平均评分（术前2.6±4.3至术后2.3±3.4；P =.874）无显著变化。症状出现前参与体育活动的患者百分比在手术时显著降低（从95.0%降至53.3%；P <.001）；术后无显著差异（从53.3%降至58.3%；P =.663）。术后每周体育活动频率和体育活动时长无显著差异。
与术前水平相比，接受OCLT的AMIC修复的患者术后参与体育和娱乐活动的水平相似且较低。
