This study aimed to examine the efficacy and safety of the arthroscopic treatment of osteochondral lesion of talus (OLT) and lateral ankle instability. It was hypothesized that the outcome of all-arthroscopic surgery was no worse than that of the combined open and arthroscopic surgery for treating chronic lateral ankle instability accompanied by OLT. The patients diagnosed of chronic lateral ankle instability accompanied by OLT, who were surgically treated between May 2015 and May2017, were targeted for inclusion. Specifically, patients who received the arthroscopic treatment of OLT and lateral ankle instability were enrolled in the all-arthroscopic group, while patients who received the arthroscopic treatment of OLT and open lateral ankle stabilization were enrolled in the combined open and arthroscopic group. All the patients were followed up in terms of the Karlsson Ankle Functional Score, visual analog scale (VAS) score, Tegner activity score, and American Orthopaedic Foot & Ankle Society (AOFAS) score. Meanwhile, the satisfaction and complication rates were evaluated and compared. This retrospective study included a total of 67 patients, including 32 patients in the all-arthroscopic group and 35 patients in the combined group. At a minimum of 24-month follow-up, the functional outcomes were significantly improved in both groups in relation to the preoperative condition. However, the two groups did not differ significantly from each other in terms of the Karlsson score (83.1 ± 8.2 vs 81.7 ± 9.1; P = 0.89), the VAS score (1.8 ± 1.6 vs 2.1 ± 1.7; P = 0.73), the Tegner score (5.5 ± 2.3 vs 5.0 ± 2.1; P = 0.72), and the AOFAS score (87.7 ± 7.6 vs 86.9 ± 7.3; P = 0.77). In addition, the satisfaction and complication rates exhibited no significant differences between the two groups. In comparison with the open lateral ankle stabilization and arthroscopic treatment of OLT, the all-arthroscopic procedure showed no difference in clinical outcomes at a minimum of 24-month follow-up. Despite the benefits of minimally invasive arthroscopic procedure combined with a relatively aggressive postoperative rehabilitation protocol, the clinical outcomes for patients with chronic lateral ankle instability accompanied by OLT did not yield significant improvement. The present study was carried out with the approval issued by the Institutional Review Board of Xiangya Hospital (no. 202002010).

中文翻译：

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关节镜与开放手术治疗伴有距骨骨软骨病变的慢性踝关节外侧不稳定的疗效比较

本研究旨在探讨关节镜治疗距骨骨软骨损伤（OLT）和踝关节外侧不稳定的有效性和安全性。据推测，对于治疗伴有 OLT 的慢性踝关节外侧不稳，全关节镜手术的结果并不比开放式关节镜联合手术的结果差。纳入对象为2015年5月至2017年5月期间接受手术治疗、诊断为慢性踝关节外侧不稳伴OLT的患者。具体而言，接受关节镜下OLT治疗且踝关节外侧不稳的患者纳入全关节镜组，而接受关节镜下OLT治疗并开放外侧踝关节稳定的患者纳入开放联合关节镜组。对所有患者进行Karlsson踝关节功能评分、视觉模拟量表（VAS）评分、Tegner活动评分、美国骨科足踝协会（AOFAS）评分等随访。同时评价并比较满意度和并发症发生率。这项回顾性研究共纳入 67 名患者，其中全关节镜组 32 名患者，联合组 35 名患者。经过至少 24 个月的随访，两组的功能结果较术前均有显着改善。然而，两组在Karlsson评分（83.1±8.2 vs 81.7±9.1；P = 0.89）、VAS评分（1.8±1.6 vs 2.1±1.7；P = 0.73）、 Tegner 评分（5.5 ± 2.3 vs 5.0 ± 2.1；P = 0.72）和 AOFAS 评分（87.7 ± 7.6 vs 86.9 ± 7.3；P = 0.77）。此外，两组之间的满意度和并发症发生率没有显着差异。与 OLT 的开放外侧踝关节稳定和关节镜治疗相比，全关节镜手术在至少 24 个月的随访中显示临床结果没有差异。尽管微创关节镜手术结合相对积极的术后康复方案有很多好处，但伴有 OLT 的慢性外侧踝关节不稳患者的临床结果并未产生显着改善。本研究是在湘雅医院机构审查委员会批准（批准号：202002010）下进行的。