DOUW, Section of Trauma- and Reconstructive Surgery, University Hospital Halle (Saale), Halle, Germany.
BG Trauma Center Bergmannstrost Halle, Department of Trauma- and Reconstructive Surgery, Halle, Germany.
Cartilage. 2024 Sep;15(3):229-239. doi: 10.1177/19476035231213184. Epub 2023 Dec 3.
To assess the current treatment of osteochondral lesions of the ankle (OCLA) by German-speaking foot and ankle surgeons, focusing on the management of postoperative care and rehabilitation.
A questionnaire was created by a panel of 4 experienced foot and ankle surgeons on behalf of the "Clinical Tissue Regeneration" (CTR) working group of the German Society of Orthopaedics and Trauma Surgery (DGOU), and distributed electronically to members of the CTR, participants of the German Cartilage Registry (Knorpelregister DGOU©), and members of 6 German-speaking orthopedics or sports medicine societies. Results were classified depending on the consensus within the answers (agreement ≥75% "strong tendency," 50%-74% "tendency," 25%-49% "weak tendency," <25% "no tendency").
A total of 60 participants returned the questionnaire. The main results are as follows: regarding the frequency of surgical procedures for OCLA, refixation of the fragment, retrograde drilling, and bone marrow stimulation with or without using a matrix were performed by at least 75% of the surgeons and was considered a strong tendency. There was a strong tendency to stabilize the ankle (76.7%) and perform corrective osteotomies (51.7%). In total, 75.5% and 75% of the surgeons performed bone marrow stimulation with and without using a matrix, respectively. Corrective osteotomy and ankle stabilization were performed in 64.5% and 65.2% cases, respectively. Most participants included published recommendations on postoperative rehabilitation and the return to sports activities in their postoperative management. The main surgical procedures were considered the most critical factor in influencing the postoperative management by 81% of the participants (strong tendency). Adjunct surgical procedures such as corrective osteotomy and stabilization of the ankle were considered important by 67.8% of the respondents (tendency).
The management of OCLA varies among German-speaking foot and ankle surgeons. Therefore, guidelines remain essential to standardize the management of OCLA, to achieve improved and stable results. This survey will assist clinicians and patients with rehabilitation to return to sports after treating the ankle's cartilage injury.
评估德语国家足踝外科医生治疗踝骨软骨损伤（OCLA）的现状，重点关注术后护理和康复管理。
由 4 名经验丰富的足踝外科医生组成的小组代表德国骨科创伤外科学会（DGOU）的“临床组织再生”（CTR）工作组创建了一份问卷，并通过电子邮件分发给 CTR 成员、德国软骨注册处（Knorpelregister DGOU©）参与者以及 6 个德语国家的骨科或运动医学学会成员。结果根据答案中的共识进行分类（同意率≥75%为“强烈倾向”，50%-74%为“倾向”，25%-49%为“弱倾向”，<25%为“无倾向”）。
共有 60 名参与者回复了问卷。主要结果如下：对于 OCLA 的手术频率，至少有 75%的医生会进行碎片固定、逆行钻孔和骨髓刺激，无论是否使用基质，这被认为是强烈倾向。强烈倾向于稳定踝关节（76.7%）和进行矫正性截骨术（51.7%）。总的来说，分别有 75.5%和 75%的医生进行了有和没有使用基质的骨髓刺激。分别有 64.5%和 65.2%的医生进行了矫正性截骨术和踝关节稳定术。大多数参与者在术后管理中纳入了有关术后康复和重返运动活动的已发表建议。81%的参与者（强烈倾向）认为主要手术程序是影响术后管理的最关键因素。辅助手术程序，如矫正性截骨术和踝关节稳定术，被 67.8%的受访者认为是重要的（倾向）。
德语国家的足踝外科医生对 OCLA 的治疗方法存在差异。因此，指南对于标准化 OCLA 的管理仍然至关重要，以实现改善和稳定的结果。这项调查将有助于临床医生和患者在治疗踝关节软骨损伤后康复并重返运动。
