Foot and Ankle Service, KT Lee's Orthopedic Hospital, South Korea.
Department of Orthopaedic Surgery, Dongtan Sacred Heart Hospital, Hallym University, South Korea.
Arthroscopy. 2021 May;37(5):1612-1619. doi: 10.1016/j.arthro.2020.12.206. Epub 2020 Dec 24.
To evaluate the clinical and sports-related outcomes of arthroscopic microfracture (MFx) for osteochondral lesion of the talus (OLT) in elite athletes.
The athletes who underwent arthroscopic MFx for OLTs at our institution between January 2011 and September 2015 with minimum 2 years of follow-up were reviewed. The Foot and Ankle Outcome Score, American Orthopaedic Foot & Ankle Society, and visual analog scale pain score, time and rate of "return-to-competition" (RTC, return to an official match for at least 1 minute after treatment), and rate of "return-to-play" (RTP, participation in at least 2 entire seasons after treatment) were used to evaluate the outcomes. We compared athletes who were able to RTP with those who were not.
In total, 41 patients (mean age 19.34 ± 3.76 years) were included. The mean follow-up was 54.9 ± 13.72 months. In total, 36 patients had medial lesions, and 5 patients had lateral lesions. All subscales of preoperative Foot and Ankle Outcome Score were significantly improved at the final follow-up. The mean preoperative American Orthopaedic Foot & Ankle Society score of 74.46 ± 8.10 improved to 91.62 ± 2.99 (P < .001) at the final follow-up. The mean preoperative visual analog scale pain score of 5.44 ± 1.57 improved to 2.66 ± 1.04 (P < .001). All patients achieved RTC (100%) at mean time of 5.45 ± 3.18 months, and 74.4% of patients were able to RTP. The RTP-group showed significantly smaller lesions compared to the No-RTP group (71.52 ± 43.29 vs 107.00 ± 45.28 mm, P = .009). The cut-off OLT size for predicting RTP was 84.0 mm, with a sensitivity of 90.0% and specificity of 75.9%.
All athletes were able to RTC at average of 5.45 months after MFx for OLTs with minimal subchondral involvement, and 74.4% were able to RTP. The only prognostic variable for RTP was lesion size, and its predictive cut-off was 84.0 mm.
IV, Case series.
评估关节镜下微骨折术（MFx）治疗距骨骨软骨损伤（OLT）对精英运动员的临床和运动相关结果。
回顾 2011 年 1 月至 2015 年 9 月在我院接受关节镜下 MFx 治疗 OLT 并至少随访 2 年的运动员。使用足部和踝关节结局评分（Foot and Ankle Outcome Score）、美国矫形足踝协会（American Orthopaedic Foot & Ankle Society）评分和视觉模拟评分（visual analog scale pain score）评估临床结果，包括“重返比赛（RTC）”时间和比率（治疗后至少 1 分钟重返比赛）以及“重返运动（RTP）”率（治疗后至少参加 2 个完整赛季）。我们比较了能够重返比赛的运动员和不能重返比赛的运动员。
共纳入 41 名患者（平均年龄 19.34 ± 3.76 岁）。平均随访时间为 54.9 ± 13.72 个月。共有 36 例患者为内侧病变，5 例为外侧病变。术前足部和踝关节结局评分的所有亚量表在末次随访时均显著改善。术前美国矫形足踝协会评分的平均得分从 74.46 ± 8.10 提高到 91.62 ± 2.99（P<.001）。术前平均视觉模拟评分从 5.44 ± 1.57 改善至 2.66 ± 1.04（P<.001）。所有患者在平均 5.45 ± 3.18 个月时均达到 RTC（100%），74.4%的患者能够重返比赛。RTP 组的病变明显小于非 RTP 组（71.52 ± 43.29 比 107.00 ± 45.28 mm，P=.009）。预测 RTP 的 OLT 大小截断值为 84.0 mm，敏感性为 90.0%，特异性为 75.9%。
所有运动员在接受 MFx 治疗 OLT 后平均 5.45 个月时均能达到 RTC，且最小程度地累及软骨下骨，74.4%的运动员能够重返比赛。RTP 的唯一预测变量是病变大小，其预测截断值为 84.0 mm。
IV，病例系列。
