Zhang Minghua, Chen Daohua, Wang Qiang, Li Ying, Huang Shiming, Zhan Peng, Lai Jiajing, Jiang Jianqing, Chen Dongfeng
Department of Bone and Joint Sports Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.
Front Surg. 2023 Jan 13;9:1072586. doi: 10.3389/fsurg.2022.1072586. eCollection 2022.
This study was performed to compare the clinical effect of arthroscopic debridement vs. arthroscopic microfracture in the treatment of osteochondral lesions of the talus.
We retrospectively reviewed patients with osteochondral lesion of talus who were admitted to our hospital from April 2020 to April 2021. The patients were divided into Group A (arthroscopic debridement group, = 39) and Group B (arthroscopic microfracture group, = 42), and the intraoperative details in the two groups were analyzed. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were compared between the two groups before surgery and at the last follow-up.
The postoperative AOFAS score (Group A, 40.9-82.26; Group B, 38.12-87.38), VAS score (Group A, 6.44-3.92; Group B, 6.38-2.05) significantly improved in both groups, but the improvement was significantly greater in Group B than in Group A (< 0.05). Among all patients, the AOFAS and VAS scores of men aged ≤30 years and patients with a low body mass index (BMI) improved more significantly (< 0.05).
The arthroscopic microfracture for the treatment of osteochondral lesion of talus is superior to joint debridement in terms of improving ankle function, especially in relatively young men with a relatively low BMI.
本研究旨在比较关节镜下清创术与关节镜下微骨折术治疗距骨骨软骨损伤的临床效果。
我们回顾性分析了2020年4月至2021年4月我院收治的距骨骨软骨损伤患者。将患者分为A组（关节镜下清创组，n = 39）和B组（关节镜下微骨折组，n = 42），并分析两组的术中细节。比较两组术前及末次随访时的美国矫形足踝协会（AOFAS）评分和视觉模拟量表（VAS）评分。
两组术后AOFAS评分（A组，40.9 - 82.26；B组，38.12 - 87.38）、VAS评分（A组，6.44 - 3.92；B组，6.38 - 2.05）均显著改善，但B组改善程度明显大于A组（P < 0.05）。在所有患者中，年龄≤30岁的男性和体重指数（BMI）较低的患者的AOFAS和VAS评分改善更显著（P < 0.05）。
关节镜下微骨折术治疗距骨骨软骨损伤在改善踝关节功能方面优于关节清创术，尤其是在BMI相对较低的年轻男性中。
