Krause Fabian, Anwander Helen
Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
EFORT Open Rev. 2022 May 31;7(6):337-343. doi: 10.1530/EOR-22-0024.
Osteochondral lesion of the talus (OLT) often occurs after ankle trauma or repetitive micro-traumata, whereas the actual etiology remains unclear. The most common symptoms are local pain deep in the medial or lateral ankle that increases with weight-bearing and activity, accompanied by tenderness and swelling. Eventually, most patients with symptomatic or unstable OLT require surgery. Many reasonable operative techniques have been described, whereas most lead to similar and satisfactory results. They can be divided into cartilage repair, cartilage regeneration and cartilage replacement techniques. The OLT size and morphology in the first place but also surgeon and individual patient aspects are considered when it comes to surgery. For high postoperative success and low recurrence rates, underlying causes, for example, ligamentous instability and hindfoot malalignment should also be addressed during surgery.
距骨骨软骨损伤（OLT）常发生于踝关节创伤或反复微小创伤后，但其实际病因仍不清楚。最常见的症状是内踝或外踝深部局部疼痛，负重和活动时加重，伴有压痛和肿胀。最终，大多数有症状或不稳定的OLT患者需要手术治疗。已经描述了许多合理的手术技术，而大多数技术都能取得相似且令人满意的结果。这些技术可分为软骨修复、软骨再生和软骨置换技术。手术时首先要考虑OLT的大小和形态，同时也要考虑外科医生和患者个体的因素。为了获得较高的术后成功率和较低的复发率，手术时还应解决潜在病因，如韧带不稳定和后足畸形。
