Purpose

The purpose of this study was to compare patients with osteochondral lesions of the talus (OCLT) with and without concomitant chronic ankle instability (CAI).

Methods

Data from the German Cartilage Registry (KnorpelRegister DGOU) for 63 patients with a solitary OCLT were used. All patients received autologous matrix-induced chondrogenesis (AMIC) for OCLT treatment. Patients in group A received an additional ankle stabilisation, while patients in group B received AMIC alone. Both groups were compared according to demographic, lesion-related, and therapy-related factors as well as baseline clinical outcome scores at the time of surgery. The Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), and the Numeric Rating Scale for Pain (NRS) were used.

Results

Patients in group A were older compared to group B [median 34 years (range 20–65 years) vs. 28.5 years (range 18–72 years)]; the rate of trauma-associated OCLTs was higher (89.7% vs. 38.3%); more patients in group A had a previous non-surgical treatment (74.1% vs. 41.4%); and their OCLT lesion size was smaller [median 100 mm² (range 15–600 mm²) vs. 150 mm² (range 25–448 mm²)]. Most OCLTs were located medially in the coronary plane and centrally in the sagittal plane in both groups. Patients in group A had worse scores on the FAOS quality-of-life subscale compared to patients in group B.

Conclusion

Patients with OCLT with concomitant CAI differ from those without concomitant CAI according to demographic and lesion-related factors. The additional presence of CAI worsens the quality of life of patients with OCLT. Patients with OCLT should be examined for concomitant CAI, so that if CAI is present, it can be integrated into the treatment concept.

Level of evidence

IV.

中文翻译：

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伴随的踝关节不稳定对距骨骨软骨病变患者的生活质量有负面影响：来自德国软骨登记处 (KnorpelRegister DGOU) 的数据。

目的

本研究的目的是比较患有和不伴有慢性踝关节不稳定 (CAI) 的距骨骨软骨病变 (OCLT) 的患者。

方法

使用了来自德国软骨登记处 (KnorpelRegister DGOU) 的 63 名孤立性 OCLT 患者的数据。所有患者均接受自体基质诱导软骨形成 (AMIC) 以进行 OCLT 治疗。A 组患者接受了额外的踝关节稳定治疗，而 B 组患者仅接受了 AMIC。根据人口统计学、病变相关和治疗相关因素以及手术时的基线临床结果评分对两组进行比较。使用足部和踝关节能力测量 (FAAM)、足部和踝部结果评分 (FAOS) 以及疼痛数字评定量表 (NRS)。

结果

与 B 组相比，A 组的患者年龄更大 [中位 34 岁（范围 20-65 岁）vs. 28.5 岁（范围 18-72 岁）]；与创伤相关的 OCLT 发生率更高（89.7% 对 38.3%）；A 组中更多的患者之前接受过非手术治疗（74.1% 对 41.4%）；并且他们的 OCLT 病灶尺寸较小 [中位数 100 mm ² (范围 15–600 mm ² ) vs. 150 mm ² (范围 25–448 mm ² )]。两组的大多数 OCLT 位于冠状平面的内侧和矢状面的中央。与 B 组患者相比，A 组患者在 FAOS 生活质量量表上的得分更差。

结论

根据人口统计学和病变相关因素，OCLT 合并 CAI 患者与未合并 CAI 的患者不同。CAI 的额外存在会恶化 OCLT 患者的生活质量。OCLT 患者应检查是否存在 CAI，以便在存在 CAI 时将其整合到治疗概念中。

证据水平

四、