Richter Alena, Altemeier Anna, Becher Christoph, Ettinger Sarah, Güllmann Marco, Plaass Christian
Diakovere Annastift, Orthopedic Clinic of Hanover Medical School, Hannover, Germany.
University Hospital for Orthopaedic and Trauma Surgery, Pius Hospital Oldenburg, Oldenburg, Germany.
Arch Orthop Trauma Surg. 2025 Feb 1;145(1):151. doi: 10.1007/s00402-025-05770-7.
The influence of patient age on the clinical outcome of surgically treated osteochondral lesions of the talus (OCT) is controversial. Aim of this study was to evaluate the 24 months follow-up data of the German Cartilage Registry (KnorpelRegister DGOU, GCR) regarding the influence of patient age on clinical outcomes after surgical OCT treatment.
303 patients met the inclusion criteria and were divided into patients < 40 years (27.1 ± 5.8 years, n = 177) and patients ≥ 40 years (50.8 ± 7.4 years, n = 126). Pre- and postoperative FAOS total scores, subscores and ΔFAOS for most frequent surgical techniques (bone marrow stimulation, matrix-augmented bone marrow stimulation, matrix-augmented bone marrow stimulation with additional bone grafting) and lesion size characteristics were evaluated for both groups. ANOVA analysis with post hoc Duncan test was applied for statistical analysis.
Both patients < 40 years and patients ≥ 40 years benefit from surgical treatment of OCT showing significant changes from pre- to postoperative FAOS total score (63.8 ± 20.3 to 81.5 ± 17.8 in patients < 40 years, p < 0.001; 57.3 ± 20.1 to 74.9 ± 21.6 in patients ≥ 40 years, p < 0.001) and subscores. Younger patient group tended to higher pre- and postoperative scores. ΔFAOS was not different between both groups. Older patient group had significantly higher lesion size area and volume; proportion of additional bone grafting was increased.
Results of surgical therapy of OCTs are independent from patient age. There is no superiority of a specific surgical technique depending on patient age.
患者年龄对手术治疗距骨骨软骨损伤(OCT)临床结果的影响存在争议。本研究的目的是评估德国软骨登记处(KnorpelRegister DGOU,GCR)24个月的随访数据,以了解患者年龄对手术治疗OCT后临床结果的影响。
303例患者符合纳入标准,分为年龄<40岁(27.1±5.8岁,n = 177)和年龄≥40岁(50.8±7.4岁,n = 126)两组。评估了两组患者术前和术后最常用手术技术(骨髓刺激、基质增强骨髓刺激、基质增强骨髓刺激加额外植骨)的FAOS总分、子分数和ΔFAOS以及病变大小特征。采用方差分析和事后邓肯检验进行统计分析。
年龄<40岁和年龄≥40岁的患者均从OCT手术治疗中获益,术前至术后FAOS总分均有显著变化(年龄<40岁患者从63.8±20.3变为81.5±17.8,p<0.001;年龄≥40岁患者从57.3±20.1变为74.9±21.6,p<0.001)以及子分数。年轻患者组术前和术后分数往往更高。两组间ΔFAOS无差异。老年患者组病变大小面积和体积显著更大;额外植骨的比例增加。
OCT手术治疗结果与患者年龄无关。不存在取决于患者年龄的特定手术技术优势。