Purpose

(1) To determine the rate of return to play following autologous osteochondral transplantation (AOT) for osteochondral lesions of the talus (OLT) and (2) report subsequent rehabilitation protocols.

Methods

A systematic review of the PubMed, Embase, and The Cochrane Library databases was performed according to the PRISMA guidelines based on specific eligibility criteria. Return to play data was meta-analysed and subsequent rehabilitation protocols were summarised. Level of evidence and quality of evidence (Zaman’s criteria) were also evaluated.

Results

Nine studies that totalled 205 ankles were included for review. The mean follow-up was 44.4 ± 25.0 (range 16–84) months. The mean OLT size was 135.4 ± 56.4 mm². The mean time to return to play was 5.8 ± 2.6 months. The mean rate of return to play was 86.3% (range 50–95.2%), with 81.8% of athletes returning to pre-injury status. Based on the fixed-effect model, the rate of return to play was 84.07%. Significant correlation was found between increase age and decrease rate of return to play (R² = 0.362, p = 0.00056). There was no correlation between OLT sizes and rate of return to play (R² = 0.140, p = 0.023). The most common time to ankle motion post-surgery was immediately and the most common time to full weight-bearing was 12 weeks.

Conclusions

This systematic review indicated a high rate of return to play following AOT in the athletic population. Size of OLT was not found to be a predictor of return to play, whereas advancing age was a predictor. Rehabilitation protocols were largely inconsistent and were primarily based on individual surgeon protocols. However, the included studies were of low level and quality of evidence.

Level of evidence

Level IV.

中文翻译：

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自体骨软骨移植治疗距骨骨软骨损伤：运动人群的高回报率。

目的

（1）确定自体骨软骨移植（AOT）后距骨骨软骨损伤（OLT）的恢复率，以及（2）报告随后的康复方案。

方法

根据PRISMA指南，基于特定的资格标准，对PubMed，Embase和Cochrane图书馆数据库进行了系统评价。对比赛数据进行了荟萃分析，并对随后的康复方案进行了总结。还评估了证据水平和证据质量（萨曼标准）。

结果

九项研究共计205个脚踝被纳入审查。平均随访时间为44.4±25.0（范围16-84）个月。OLT的平均大小为135.4±56.4 mm ²。恢复比赛的平均时间为5.8±2.6个月。平均比赛回报率为86.3％（范围为50-95.2％），其中81.8％的运动员恢复了受伤前状态。根据固定效应模型，游戏的收益率为84.07％。发现增加的年龄和减少的游戏收益率之间存在显着的相关性（R ²  = 0.362，p  = 0.00056）。OLT的大小和游戏的回报率之间没有相关性（R ²  = 0.140，p = 0.023）。术后踝关节运动最常见的时间是立即进行，而完全负重的最常见时间是12周。

结论

这项系统的评估表明，运动人群中AOT后的比赛回报率很高。没有发现OLT的大小是恢复比赛的预测因素，而年龄的增长却是预测因素。康复方案在很大程度上是不一致的，并且主要基于个体外科医生方案。但是，纳入的研究证据水平低且质量高。

证据水平

第四级。