Return to Sports Activity After Microfracture for Osteochondral Lesion of the Talus in Skeletally Immature Children

IF 2.4 2区医学 Q2 ORTHOPEDICS

Foot & Ankle International Pub Date : 2024-04-04 DOI:10.1177/10711007241241067

Seiya Tomonaga, Ichiro Yoshimura, Tomonobu Hagio, Tetsuro Ishimatsu, Yuki Sugino, Ryo Fukagawa, Yoshimasa Taniguchi, Takuaki Yamamoto

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引用次数: 0

Abstract

Background:Osteochondral lesions of the talus (OLTs) are among the common sports-related injuries. However, there are few reports on the return to sports after OLT surgery in skeletally immature children. This study was performed to evaluate the return to sports after microfracture for OLTs in skeletally immature children.Methods:This study involved 17 ankles of 16 patients (mean age, 13.2 years; range, 10-16 years) with open tibial epiphyses on magnetic resonance imaging (MRI) who underwent microfracture for OLTs <10 mm in diameter and confirmation of lesion instability under arthroscopy. Nine of 17 ankles had additional lateral ankle ligament stabilization. All patients were participating in some form of sports. The Japanese Society for Surgery of the Foot (JSSF) score, Ankle Activity Score (AAS), return to sports rate, lesion size, grade of subchondral bone marrow edema, and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score on MRI were evaluated after microfracture. The mean postoperative follow-up period was 53.5 months.Results:The mean JSSF score significantly improved from 76.1 points preoperatively to 94.9 points at the final follow-up ( P < .01). The mean AAS showed no change from preoperative state to final follow-up. The return to sports rate was 100%. The lesion size significantly decreased from 76.3 to 56.7 mm2 in area ( P = .02) and from 283.2 to 185.6 mm3 in volume ( P = .05). The bone marrow edema grade decreased in 8 of 17 ankles. The total MOCART score showed a significant improvement from 6 months to 1 year postoperatively ( P = .05).Conclusion:All skeletally immature children who underwent microfracture for OLTs in this study were able to return to sports activity and showed improvements in clinical scores and MRI parameters. Microfracture may be considered an effective first-line treatment for OLTs <10 mm in diameter in skeletally immature athletes.Level of Evidence:Level IV, retrospective case-control study.

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骨骼未成熟儿童距骨骨软骨损伤微骨折术后恢复体育活动

背景：距骨软骨损伤（OLT）是常见的运动相关损伤之一。然而，关于骨骼尚未发育成熟的儿童接受 OLT 手术后恢复运动的报道却很少。本研究旨在评估骨骼尚未发育成熟的儿童接受 OLTs 显微骨折术后恢复运动的情况。方法：本研究涉及 16 名患者的 17 只脚踝（平均年龄 13.2 岁；范围 10-16 岁），这些患者的胫骨骺在磁共振成像（MRI）上显示为开放性，他们接受了直径为 10 毫米的 OLTs 显微骨折术，并在关节镜下确认了病变的不稳定性。17 个脚踝中的 9 个需要额外的外侧踝关节韧带稳定。所有患者都参加了某种形式的运动。微骨折术后评估了日本足外科协会（JSSF）评分、踝关节活动评分（AAS）、恢复运动率、病变大小、软骨下骨髓水肿等级以及核磁共振软骨修复组织磁共振观察（MOCART）评分。结果：JSSF 平均得分从术前的 76.1 分显著提高到最终随访时的 94.9 分（P <.01）。AAS平均值与术前相比没有变化。运动恢复率为 100%。病灶面积从 76.3 平方毫米大幅减少到 56.7 平方毫米（P = .02），体积从 283.2 立方毫米减少到 185.6 立方毫米（P = .05）。17只脚踝中有8只的骨髓水肿等级有所下降。结论：在本研究中，所有骨骼尚未发育成熟的儿童在接受了OLT微骨折术后都能恢复体育活动，并在临床评分和磁共振成像参数方面有所改善。对于骨骼尚未发育成熟的运动员，微骨折可被视为治疗直径为10毫米的OLTs的有效一线疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot & Ankle International 医学-整形外科

CiteScore

5.60

自引率

22.20%

发文量

144

审稿时长

2 months

期刊介绍： Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers. The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008. The journal focuses on the following areas of interest: • Surgery • Wound care • Bone healing • Pain management • In-office orthotic systems • Diabetes • Sports medicine