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踝关节不稳与距骨骨软骨损伤患者的生活质量呈负相关:来自德国软骨注册库(DGOU 软骨注册库)的数据。

Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German Cartilage Registry (KnorpelRegister DGOU).

机构信息

Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany.

Department of Orthopaedics and Special Trauma Surgery, Klinikum Mittleres Erzgebirge gGmbH, Zschopau, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Oct;28(10):3339-3346. doi: 10.1007/s00167-020-05954-1. Epub 2020 Apr 2.

Abstract

PURPOSE

The purpose of this study was to compare patients with osteochondral lesions of the talus (OCLT) with and without concomitant chronic ankle instability (CAI).

METHODS

Data from the German Cartilage Registry (KnorpelRegister DGOU) for 63 patients with a solitary OCLT were used. All patients received autologous matrix-induced chondrogenesis (AMIC) for OCLT treatment. Patients in group A received an additional ankle stabilisation, while patients in group B received AMIC alone. Both groups were compared according to demographic, lesion-related, and therapy-related factors as well as baseline clinical outcome scores at the time of surgery. The Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), and the Numeric Rating Scale for Pain (NRS) were used.

RESULTS

Patients in group A were older compared to group B [median 34 years (range 20-65 years) vs. 28.5 years (range 18-72 years)]; the rate of trauma-associated OCLTs was higher (89.7% vs. 38.3%); more patients in group A had a previous non-surgical treatment (74.1% vs. 41.4%); and their OCLT lesion size was smaller [median 100 mm (range 15-600 mm) vs. 150 mm (range 25-448 mm)]. Most OCLTs were located medially in the coronary plane and centrally in the sagittal plane in both groups. Patients in group A had worse scores on the FAOS quality-of-life subscale compared to patients in group B.

CONCLUSION

Patients with OCLT with concomitant CAI differ from those without concomitant CAI according to demographic and lesion-related factors. The additional presence of CAI worsens the quality of life of patients with OCLT. Patients with OCLT should be examined for concomitant CAI, so that if CAI is present, it can be integrated into the treatment concept.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究旨在比较伴有和不伴有慢性踝关节不稳(CAI)的距骨骨软骨病变(OCLT)患者。

方法

使用德国软骨注册处(KnorpelRegister DGOU)的数据,纳入 63 例孤立性 OCLT 患者。所有患者均接受自体基质诱导软骨生成术(AMIC)治疗 OCLT。A 组患者接受额外的踝关节稳定治疗,B 组患者仅接受 AMIC 治疗。比较两组患者的人口统计学、病变相关和治疗相关因素以及手术时的基线临床结局评分。采用足踝能力测量(FAAM)、足踝结局评分(FAOS)和疼痛数字评分量表(NRS)进行评估。

结果

与 B 组相比,A 组患者年龄更大[中位数 34 岁(范围 20-65 岁)比 28.5 岁(范围 18-72 岁)];创伤相关 OCLT 发生率更高(89.7%比 38.3%);A 组中更多的患者接受过非手术治疗(74.1%比 41.4%);OCLT 病变大小更小[中位数 100mm(范围 15-600mm)比 150mm(范围 25-448mm)]。两组患者 OCLT 均主要位于冠状面的内侧和矢状面的中央。与 B 组相比,A 组患者 FAOS 生活质量子量表评分更差。

结论

伴有 CAI 的 OCLT 患者与不伴有 CAI 的 OCLT 患者在人口统计学和病变相关因素方面存在差异。额外存在 CAI 会降低 OCLT 患者的生活质量。OCLT 患者应检查是否存在 CAI,如果存在 CAI,则应将其纳入治疗方案。

证据等级

IV。

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