Foot and Ankle Division, Department of Orthopaedic Surgery, NYU Langone Health, 171 Delancey Street, New York, NY 10002, USA.
Foot and Ankle Division, Department of Orthopaedic Surgery, NYU Langone Health, 171 Delancey Street, New York, NY 10002, USA; University of Cambrdige School of Clinical Medicine, Box 111 Cambridge Biomedical Campus, Cambridge CB2 0SP, UK.
Orthop Clin North Am. 2023 Apr;54(2):227-236. doi: 10.1016/j.ocl.2022.11.007. Epub 2023 Jan 31.
Osteochondral lesions of the ankle joint are typically associated with a traumatic etiology and present with ankle pain and swelling. Conservative management yields unsatisfactory results because of the poor healing capacity of the articular cartilage. Smaller lesions (<100 mm or <10 mm) can be treated with less invasive procedures such as arthroscopic debridement, anterograde drilling, scaffold-based therapies, and augmentation with biological adjuvants. For patients with large lesions (>100 mm or >10 mm), cystic lesions, uncontained lesions, or patients who have failed prior bone marrow stimulation, management with autologous osteochondral transplantation is indicated.
踝关节的骨软骨损伤通常与创伤有关,表现为踝关节疼痛和肿胀。由于关节软骨的愈合能力差,保守治疗的效果并不理想。较小的损伤(<100mm 或 <10mm)可以通过关节镜清理术、顺行钻孔、支架基治疗和生物佐剂增强等侵袭性较小的方法进行治疗。对于大的损伤(>100mm 或 >10mm)、囊性病变、非包容性病变或先前骨髓刺激治疗失败的患者,需要进行自体骨软骨移植治疗。