Sheu Christopher, Ferkel Richard D
Skagit Regional Health, Mount Vernon, Washington, USA.
Southern California Orthopedic Institute, Van Nuys, California, USA.
Orthop J Sports Med. 2021 Jan 6;9(1):2325967120970205. doi: 10.1177/2325967120970205. eCollection 2021 Jan.
Use of marrow-stimulating techniques to treat osteochondral lesions of the talus (OLTs) in National Basketball Association (NBA) players is controversial.
NBA players will be able to return to preinjury playing status after treatment of OLTs by arthroscopic debridement alone without marrow-stimulating techniques.
Cohort study; Level of evidence, 3.
Between the 2000 and 2015 seasons, 10 NBA players were treated with arthroscopic debridement of an OLT. The following performance outcomes were compared pre- and postoperatively: seasons played, games played, games started, minutes per game, points per game, field goals, 3-point shots, rebounds, assists, double doubles, triple doubles, steals, blocks, turnovers, personal fouls, assists per turnovers, steals per turnovers, NBA rating, scoring efficiency, and shooting efficiency. In addition, the players were compared with a matched control group using mixed effects regression and Fisher least significant difference modeling.
All 10 players returned to play in the NBA after arthroscopic debridement without microfracture or drilling of an OLT. When compared with preoperative performance, postoperative mean points scored, assists made, and steals made increased by 2.86 ( = .042), 0.61 ( = .049), and 0.15 ( = .027), respectively. Only field goal percentage decreased postoperatively when compared with matched controls; however, this normalized by the end of the second season after surgery. There was no statistically significant change in any of the other performance factors when compared with matched controls. All patients returned to basketball during the same season (n = 1) or the following season (n = 9) if the operation was performed off-season. The mean length of career after surgery was 4.1 years, with 5 players still playing in the league at the time of this study.
After arthroscopic debridement of an OLT without drilling or microfracture, there was a high rate of return to the NBA, with improved points scored, assists, and steals made after surgery when compared with preoperative performance. There was no statistically significant change in any performance factors when compared with uninjured matched controls. Lesion size did not affect player career length. These data should be used to manage patients' and teams' expectations regarding players' ability to return to elite levels of athletic performance after surgery of an OLT.
在国家篮球协会（NBA）球员中，使用骨髓刺激技术治疗距骨骨软骨损伤（OLTs）存在争议。
NBA球员在仅通过关节镜清创术而非骨髓刺激技术治疗OLTs后，将能够恢复到伤前的比赛状态。
队列研究；证据等级，3级。
在2000年至2015年赛季期间，10名NBA球员接受了OLTs的关节镜清创术。比较了术前和术后的以下表现结果：参赛赛季数、参赛场次、首发场次、场均分钟数、场均得分、投篮命中数、三分球命中数、篮板数、助攻数、两双次数、三双次数、抢断数、盖帽数、失误数、个人犯规数、助攻失误比、抢断失误比、NBA评分、得分效率和投篮效率。此外，使用混合效应回归和Fisher最小显著差异模型将这些球员与匹配的对照组进行比较。
所有10名球员在接受OLTs的关节镜清创术且未进行微骨折或钻孔后重返NBA比赛。与术前表现相比，术后场均得分、助攻数和抢断数分别增加了2.86（P = 0.042）、0.61（P = 0.049）和0.15（P = 0.027）。与匹配对照组相比，术后只有投篮命中率下降；然而，在术后第二个赛季末恢复正常。与匹配对照组相比，其他任何表现因素均无统计学上的显著变化。如果手术在非赛季进行，所有患者均在同一赛季（n = 1）或接下来的赛季（n = 9）重返篮球赛场。术后职业生涯的平均时长为4.1年，在本研究进行时，有5名球员仍在联盟中打球。
在未进行钻孔或微骨折的情况下对OLTs进行关节镜清创术后，重返NBA的比例很高，与术前表现相比，术后得分、助攻和抢断有所改善。与未受伤的匹配对照组相比，任何表现因素均无统计学上的显著变化。损伤大小不影响球员的职业生涯时长。这些数据应用于管理患者和球队对球员在OLTs手术后恢复到精英运动表现水平能力的期望。
