Department of Sports Medicine, Peking University Third Hospital. Institute of Sports Medicine of Peking University. Beijing Key Laboratory of Sports Injuries, Beijing, China.
Department of Sports Medicine, Peking University Third Hospital. Institute of Sports Medicine of Peking University. Beijing Key Laboratory of Sports Injuries, Beijing, China.
Arthroscopy. 2023 Oct;39(10):2191-2199.e1. doi: 10.1016/j.arthro.2023.03.029. Epub 2023 Apr 25.
To study the effects of concomitant subchondral bone cysts (SBCs) on prognosis after arthroscopic bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLTs) less than 100 mm and to further assess the correlation between cystic OLT area, depth, or volume and postoperative outcomes.
We retrospectively analyzed consecutive patients with OLTs (<100 mm) who received BMS between April 2017 and May 2020 with a minimum follow-up of 24 months. Lesion area, depth, and volume were collected on preoperative magnetic resonance imaging. Visual analog scale (VAS), American Orthopedic Foot and Ankle Society, Karlsson-Peterson, Tegner, Foot and Ankle Ability Measure (FAAM)-Activities of Daily Life and Sports scores were assessed before surgery and at the latest follow-up. Additionally, a general linear model (GLM) and a Pearson correlation analysis (PCA) were performed to investigate the effects of concomitant cysts on postoperative results.
Eighty-two patients with a mean follow-up of 39.22 ± 12.53 months were divided into non-cyst (n = 45; 39.91 ± 13.03 months) and cyst (n = 37; 38.37 ± 12.02 months) groups. There was no significant difference in the OLT area between the non-cyst and cyst groups (46.98 ± 19.95 mm vs 56.08 ± 22.92 mm; P = .093), but the cyst group showed significantly greater depth (6.06 ± 1.99 mm vs 3.96 ± 1.44 mm; P = .000) and volume (248.26 ± 156.81 mm vs 134.58 ± 89.68 mm; P = .002). The non-cyst group showed significantly more improvement in VAS pain, Karlsson-Peterson, Tegner, and FAAM scores than the cyst group (P < .05). The GLM indicated that SBCs negatively affected VAS pain and Tegner scores (P < .05). For OLTs with cysts, the PCA showed that an area of 90.91 mm, depth of 7.56 mm, and volume of 428.13 mm were potential cutoff values associated with poor outcomes.
The concomitant SBCs negatively affected the prognosis of OLTs after BMS. For OLTs with cysts, an area of 90.91 mm, depth of 7.56 mm, and volume of 428.13 mm were the potential cutoff values associated with poor outcomes after BMS.
Level III, retrospective comparative study.
研究软骨下骨囊肿（SBC）对关节镜下骨髓刺激（BMS）治疗小于 100mm 的距骨骨软骨病变（OLTs）后预后的影响，并进一步评估囊肿性 OLT 面积、深度或体积与术后结果的相关性。
我们回顾性分析了 2017 年 4 月至 2020 年 5 月期间接受 BMS 治疗的 OLTs（<100mm）的连续患者，随访时间至少为 24 个月。术前磁共振成像采集病变面积、深度和体积。术前和末次随访时评估视觉模拟评分（VAS）、美国矫形足踝协会（AOFAS）、Karlsson-Peterson、Tegner、Foot and Ankle Ability Measure（FAAM）-日常生活和运动评分。此外，还进行了一般线性模型（GLM）和 Pearson 相关分析（PCA），以研究伴随囊肿对术后结果的影响。
82 例患者平均随访 39.22±12.53 个月，分为非囊肿组（n=45；39.91±13.03 个月）和囊肿组（n=37；38.37±12.02 个月）。非囊肿组和囊肿组的 OLT 面积无显著差异（46.98±19.95mm vs 56.08±22.92mm；P=0.093），但囊肿组的深度（6.06±1.99mm vs 3.96±1.44mm；P=0.000）和体积（248.26±156.81mm vs 134.58±89.68mm；P=0.002）明显更大。非囊肿组 VAS 疼痛、Karlsson-Peterson、Tegner 和 FAAM 评分的改善明显优于囊肿组（P<0.05）。GLM 表明 SBC 对 VAS 疼痛和 Tegner 评分有负面影响（P<0.05）。对于有囊肿的 OLTs，PCA 显示面积为 90.91mm、深度为 7.56mm 和体积为 428.13mm 是与 BMS 后不良结果相关的潜在截断值。
伴随 SBC 会对 BMS 治疗 OLTs 的预后产生负面影响。对于有囊肿的 OLTs，面积为 90.91mm、深度为 7.56mm 和体积为 428.13mm 是与 BMS 后不良结果相关的潜在截断值。
III 级，回顾性比较研究。
