Second-Look Arthroscopic Findings and Clinical Outcomes After Microfracture for Osteochondral Lesions of the Talus
Second-Look Arthroscopic Findings and Clinical Outcomes After Microfracture for Osteochondral Lesions of the Talus
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DOI：
10.1177/0363546509348471
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发表时间：
2009-11-01
影响因子：
4.8
通讯作者：
Seon, Jong-Keun
中科院分区：
文献类型：
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作者：
Lee, Keun-Bae;Bai, Long-Bin;Seon, Jong-Keun
背景：关节镜下微骨折常用于距骨软骨损伤的修复。然而，尽管这项技术很受欢迎，但尚未有关于二次关节镜下微骨折后软骨修复的研究。目的：本研究的目的是通过二次关节镜评估距骨软骨病变的软骨修复，并将关节镜检查结果与术后12个月的临床结果进行比较。研究设计：病例系列；证据等级，4级。方法：对19例患者的20个踝关节于术后12个月行二次关节镜检查。关节镜检查结果采用Ferkel和Cheng分期系统进行分类，软骨修复使用国际软骨修复系统（ICRS）进行评估。临床结果采用美国矫形足踝协会（AOFAS）踝关节-后足量表进行评估。结果：根据二次关节镜Ferkel和Cheng分期，20例踝关节中有7例（35%）表现为不完全愈合（D期）。ICRS整体修复等级方面，8例（40%）踝关节异常（111级）。Ferkel和Cheng A ~ C期（n = 13）和D期（n = 7）的AOFAS平均评分分别为88.5分和82.0分，ICRS修复I级和11级（n = 12）和III级（n = 8）的AOFAS平均评分分别为88.7分和82.5分。AOFAS评分与Ferkel和Cheng分期及ICRS评分有良好的相关性。总体而言，90%的踝关节达到了优秀或良好的AOFAS分数超过80分。结论：距骨软骨病变微骨折术后12个月复查关节镜显示，40%的病变未完全愈合。然而，大多数患者获得了良好的临床结果。此外，发现术后临床评分与ICRS修复等级相关。
Background: Arthroscopic microfracture is frequently used to repair osteochondral lesions of the talus. However, despite the popularity of this technique, no study has been conducted on cartilage repair after microfracture by second-look arthroscopy.Purpose: The purpose of the present study was to evaluate cartilage repair in osteochondral lesions of the talus by second-look arthroscopy and to compare arthroscopic findings with clinical outcomes 12 months postoperatively.Study Design: Case series; Level of evidence, 4.Methods: Second-look arthroscopies were performed in 20 ankles of 19 patients at 12 months postoperatively. Arthroscopic findings were classified using the Ferkel and Cheng staging system, and cartilage repair was assessed using the International Cartilage Repair System (ICRS). Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.Results: According to the Ferkel and Cheng staging at second-look arthroscopy, 7 of the 20 ankles (35%) showed incomplete healing (stage D). In terms of ICRS overall repair grades, 8 ankles (40%) were abnormal (grade 111). Mean AOFAS scores for Ferkel and Cheng stages A to C (n = 13) and stage D (n = 7) were 88.5 and 82.0 points, and those for ICRS repair grades I and 11 (n = 12) and grade III (n = 8) were 88.7 and 82.5, respectively. Good correlations were found between AOFAS scores and Ferkel and Cheng stages and ICRS grades. Overall, 90% of ankles achieved an excellent or good AOFAS score of over 80 points.Conclusion: Second-look arthroscopic findings at 12 months postoperatively after microfracture for osteochondral lesions of the talus revealed that 40% of lesions were incompletely healed. Nevertheless, the majority of patients achieved a good clinical outcome. Furthermore, postoperative clinical scores were found to be correlated with ICRS repair grades.