Surgeon-in-Charge, Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China; Department of Orthopaedics, the Third Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Physician-in-Charge, Department of Medical Insurance, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China; Department of Medical Insurance, the Third Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
J Foot Ankle Surg. 2021 Nov-Dec;60(6):1232-1240. doi: 10.1053/j.jfas.2021.04.022. Epub 2021 May 10.
Osteochondral lesions of the talus (OLT) are common injuries requiring surgery. Arthroscopic microfracture treatment is effective and acceptable. Although the concept of postoperative rehabilitation is continuously being updated, the choice between early weightbearing (EWB) versus delayed weightbearing (DWB) following microfracture is still not settled. A meta-analysis and systematic review was performed to compare the rehabilitation effect of 2 different weightbearing protocols following microfracture. Five databases were searched for relevant studies, and full-text articles comparing EWB and DWB were reviewed. Review Manager 5.3 software was used to summarize the results of the included studies. Two reviewers independently filtered the studies, assessed quality, extracted data, and estimated the risk of bias. The pain score and functional assessment of the ankle were selected as the endpoints. The mean difference was calculated as the summary statistic for continuous data. Then, visual analog scale and American Orthopedic Foot and Ankle Society scale scores were collected and pooled. Five randomized controlled trials including 283 patients were identified for this study, revealing that there was no significant difference in pain scores between EWB and DWB following microfracture 3 months, 6 months, 12 months, and 24 months postoperatively. Function assessment showed similar results. Comprehensive analysis of current evidence still suggests that EWB and DWB after microfracture of OLT produce comparable clinical outcomes in terms of pain and functional activity. Therefore, EWB is recommended to shorten the length of time before returning to work or sports after microfracture of OLT.
距骨骨软骨损伤（OLT）是常见的需要手术的损伤。关节镜下微骨折治疗是有效的且可接受的。尽管术后康复的概念在不断更新，但微骨折后早期负重（EWB）与延迟负重（DWB）的选择仍未确定。进行了一项荟萃分析和系统评价，以比较微骨折后两种不同负重方案的康复效果。检索了五个数据库以寻找相关研究，并对比较 EWB 和 DWB 的全文文章进行了回顾。使用 Review Manager 5.3 软件总结纳入研究的结果。两名审查员独立筛选研究、评估质量、提取数据和评估偏倚风险。疼痛评分和踝关节功能评估被选为终点。对于连续数据，计算了均数差作为汇总统计量。然后，收集并汇总了视觉模拟评分和美国矫形足踝协会评分。本研究共纳入 283 例患者的 5 项随机对照试验，结果显示微骨折后 3 个月、6 个月、12 个月和 24 个月，EWB 和 DWB 在疼痛评分上无显著差异。功能评估也得到了相似的结果。综合分析当前证据仍表明，OLT 微骨折后 EWB 和 DWB 在疼痛和功能活动方面产生相当的临床结果。因此，建议 EWB 可缩短 OLT 微骨折后重返工作或运动的时间。
