Arthroscopic treatment of osteochondral lesions of the Talus with correlation of outcome scoring systems
Arthroscopic treatment of osteochondral lesions of the Talus with correlation of outcome scoring systems
复制标题
DOI：
10.1053/jars.2003.50047
复制
发表时间：
2003-04-01
影响因子：
4.7
通讯作者：
Sherman, O
中科院分区：
文献类型：
--
作者：
Hunt, SA;Sherman, O
目的：本研究的目的是对关节镜治疗的距骨骨软骨损伤 (OCLT) 进行回顾性评价，以确定其结果并分析 3 个踝关节主观结果评分系统的相关性。方法：1985 年至 1999 年间，对 33 名踝关节进行了 37 例关节镜清创或软骨下钻孔手术来治疗 OCLT。对这些患者的图表进行了一般人口统计、术前、手术和术后信息的审查。病人被送去。包含 3 个主观结果评分系统的问卷：马丁评分问卷；伯恩特和哈蒂量表；以及单一评估数值评估 (SANE) 问题。二十八人回答了调查问卷。二十四名患者报告有外伤史。距骨内侧17处病变，外侧10处，中央1处。根据关节镜下的外观对病变进行分类。 1 期病变 7 个，11 期病变 2 个，III 期病变 10 个，IV 期病变 9 个。分析所有数据后，在 3 个结果量表之间进行皮尔逊积矩相关系数 (r) 和确定相关性 (r)。结果：平均随访时间为 66 个月（范围：6-169 个月）。根据评分系统的不同，结果也有所不同。使用 Berndt 和 Harty 量表，13 名患者（46%）的结果良好，13 名患者（46%）的结果一般，2 名患者（8%）的结果较差。根据Martin评分，优1例（4%），良10例（35%），一般9例（32%），差8例（29%）。根据SANE评分，优5例（18%），良8例（29%），一般9例（32%），差6例（21%）。十七名患者在后续检查中报告有某种形式的疼痛。对手术年龄、病变阶段、随访时间和既往手术等变量的分析显示没有统计学意义。所有 3 个量表均呈正相关。根据这些结果数据，Berndt 和 Harty 量表与 SANE 和 Martin 结果系统均显示出良好的相关性（分别为 r = 0.81 和 r = 0.69）。 Martin 评分与 SANE 结果系统呈中等相关性 (r = .57)。结论：我们的患者群体的结果并不像之前报道的那样成功。我们的分析显示三个主观结果系统之间呈正相关。然而，由于文献中以前的报告采用了各种结果衡量标准，因此仍然很难将这些数据与以前的结果进行比较。
Purpose: The goal of this study was to perform a retrospective review of arthroscopically treated osteochondral lesions of the talus (OCLTs) to determine their outcome and to analyze the correlation of 3 subjective outcome scoring systems for the ankle. Methods: Between 1985 and 1999, 37 arthroscopic debridement or subchondral drilling procedures were performed on 33 ankles to treat OCLTs. The charts of these patients were reviewed for general demographic, preoperative, surgical, and postoperative information. Patients were sent. a questionnaire that included 3 subjective outcome scoring systems: the Martin Score questionnaire; the Berndt and Harty scale; and the Single Assessment Numeric Evaluation (SANE) question. Twenty-eight people responded to the questionnaire. Twenty-four patients reported a history of trauma. There were 17 lesions on the medial aspect of the talus, 10 laterally, and 1 centrally. The lesions were classified according to their arthroscopic appearance. There were 7 stage 1, 2 stage 11, 10 stage III, and 9 stage IV lesions. After all data were analyzed, the Pearson product-moment correlation coefficient (r) and correlation of determination (r) were performed among the 3 outcome scales. Results: The mean follow-up time was 66 months (range, 6-169 months). Outcome results varied according to the scoring system. Using the Berndt and Harty scale, 13 (46%) patients had good, 13 (46%) fair, and 2 (8%) poor results. According to the Martin Score, 1 patient (4%) had excellent, 10 (35%) good, 9 (32%) fair, and 8 (29%) had poor results. According to the SANE score, 5 patients (18%) had excellent, 8 (29%) good, 9 (32%) fair, and 6 (21%) had poor results. Seventeen patients reported some form of pain at follow-up examination. Analysis of variables, including age at operation, stage of the lesion, length of follow-up, and previous surgery revealed no statistical significance. All 3 scales showed positive correlations. Based on these outcome data, the Berndt and Harty scale showed good correlation with both the SANE and the Martin outcome systems (r = .81 and r = .69, respectively). The Martin Score showed moderate correlation with the SANE outcome system (r = .57). Conclusions: The outcome results for our patient population were not as successful as has been previously reported. Our analysis showed positive correlation among the 3 subjective outcome systems. However, it remains difficult to compare these data with previous results secondary to the variety of outcome measures employed by previous reports in the literature.