The Utilization of Patient-Reported Outcome Measures in Assessing the Treatment of Osteochondral Lesions of the Ankle Versus the Knee

Background: When assessing the outcomes of ankle and knee osteochondral lesions (OCLs), there are numerous patient-reported outcome measures (PROMs) that are used; however, not all are validated. Purpose: To compare the utilization of PROMs in assessing the treatment of ankle OCLs versus knee OCLs. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of Embase, MEDLINE, and CINAHL was conducted to identify all observational or experimental studies from January 1, 2014 to December 31, 2023 that used PROMs to assess the treatment of ankle or knee OCLs. The frequency of the use of specific validated PROMs between the ankle OCL and knee OCL literature was compared using an independent t -test. Correlation coefficients were calculated to assess differences based on journal impact factor (divided into quartiles), publication year, or level of evidence. Results: A total of 233 eligible ankle OCL studies and 211 knee OCL studies were identified. Validated clinical outcome measures were used in 41.2% of ankle OCL studies compared with 87.7% of knee OCL studies ( P < .001). There were a total of 44 outcome measures used in ankle OCL studies, with the majority of studies (67.8%) utilizing the AOFAS (American Orthopaedic Foot and Ankle Society) score. There were no correlations between the use of validated outcome measures in the ankle OCL studies and journal impact factor ( P = .78), publication year ( P = .16), or level of evidence ( P = .45). Similarly, there were no correlations for the knee OCL studies based on journal impact factor ( P = .60), publication year ( P = .25), or level of evidence ( P = .55). Conclusion: Validated clinical outcome measures were more frequently utilized in knee OCL studies compared with ankle OCL studies. The low frequency of validated outcome measures used within the ankle literature may limit how well treatment effectiveness in the management of ankle OCLs is evaluated.