Quinten G H Rikken, Jari Dahmen, Sjoerd A S Stufkens, Gino M M J Kerkhoffs
{"title":"胫骨平台骨软骨病变的非手术治疗结果轻微改善患者报告的结果：一项为期2年的前瞻性随访研究。","authors":"Quinten G H Rikken, Jari Dahmen, Sjoerd A S Stufkens, Gino M M J Kerkhoffs","doi":"10.1177/19476035251376180","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveOsteochondral lesions of the tibial plafond (OLTP) are considered rare, and to date the treatment for these lesions has solely focused on operative management. The aim of this study was to prospectively assess the 2-year patient-reported outcomes, radiological outcomes, and adverse outcomes for the non-operative treatment of patients with a symptomatic OLTP.DesignEighteen patients with a symptomatic OLTP who underwent non-operative treatment were prospectively assessed. The primary outcome concerned the numeric rating scale (NRS) for pain during weightbearing from baseline to 2-year follow-up. Secondarily, the patient-reported outcomes (PROMs) NRS during rest, running, and stairclimbing, as well as the Foot and Ankle Outcome Score (FAOS) and short-form-36 (SF-36) questionnaires were assessed. CT scans at median 2 years (IQR: 1.5-2) follow-up were reviewed for changes in lesion volume or signs of lesion healing. Return to sports and work rates were evaluated. The conversion to surgery rate and any complications were assessed.ResultsThe NRS during weightbearing improved (non-significantly) from a median of 5 (IQR: 3-7) out of 10 at baseline to 2 (IQR: 1-6) out of 10 at 2-year follow-up, <i>P</i> = 0.06. The other NRS subscales, FAOS subscales, and SF-36 did not significantly improve at final follow-up. The follow-up CT-evaluation showed that lesion volume did not change (219 [IQR: 79-890] mm<sup>3</sup>) compared to baseline (226 [IQR: 79-890] mm<sup>3</sup>), <i>P</i> = 0.2. In 10 (77%) out of 13 cases, signs of lesion filling or no change was observed. At final follow-up, 93% (13/14) of patients returned to any level of sports, 54% (7/13) of patients returned to preinjury level of sports, and 94% (15/16) of patients returned to work. No adverse events were observed, and 1 (6%) case converted to surgery.ConclusionsNon-operative management for OLTP resulted in minor improvements of patient-reported pain and functional outcomes up to 2-year follow-up. The conversion to surgery rate was 6%. Radiologically, lesion size and filling were found to remain stable at CT follow-up. Moreover, on average 9 out of 10 patients were able to participate in sport and could return to, or remain at, their preinjury work activities.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035251376180"},"PeriodicalIF":2.7000,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476373/pdf/","citationCount":"0","resultStr":"{\"title\":\"Non-Operative Management for Osteochondral Lesions of the Tibial Plafond Results in Minor Improvements of Patient-Reported Outcomes: A 2-Year Prospective Follow-Up Study.\",\"authors\":\"Quinten G H Rikken, Jari Dahmen, Sjoerd A S Stufkens, Gino M M J Kerkhoffs\",\"doi\":\"10.1177/19476035251376180\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>ObjectiveOsteochondral lesions of the tibial plafond (OLTP) are considered rare, and to date the treatment for these lesions has solely focused on operative management. The aim of this study was to prospectively assess the 2-year patient-reported outcomes, radiological outcomes, and adverse outcomes for the non-operative treatment of patients with a symptomatic OLTP.DesignEighteen patients with a symptomatic OLTP who underwent non-operative treatment were prospectively assessed. The primary outcome concerned the numeric rating scale (NRS) for pain during weightbearing from baseline to 2-year follow-up. Secondarily, the patient-reported outcomes (PROMs) NRS during rest, running, and stairclimbing, as well as the Foot and Ankle Outcome Score (FAOS) and short-form-36 (SF-36) questionnaires were assessed. CT scans at median 2 years (IQR: 1.5-2) follow-up were reviewed for changes in lesion volume or signs of lesion healing. Return to sports and work rates were evaluated. The conversion to surgery rate and any complications were assessed.ResultsThe NRS during weightbearing improved (non-significantly) from a median of 5 (IQR: 3-7) out of 10 at baseline to 2 (IQR: 1-6) out of 10 at 2-year follow-up, <i>P</i> = 0.06. The other NRS subscales, FAOS subscales, and SF-36 did not significantly improve at final follow-up. The follow-up CT-evaluation showed that lesion volume did not change (219 [IQR: 79-890] mm<sup>3</sup>) compared to baseline (226 [IQR: 79-890] mm<sup>3</sup>), <i>P</i> = 0.2. In 10 (77%) out of 13 cases, signs of lesion filling or no change was observed. At final follow-up, 93% (13/14) of patients returned to any level of sports, 54% (7/13) of patients returned to preinjury level of sports, and 94% (15/16) of patients returned to work. No adverse events were observed, and 1 (6%) case converted to surgery.ConclusionsNon-operative management for OLTP resulted in minor improvements of patient-reported pain and functional outcomes up to 2-year follow-up. The conversion to surgery rate was 6%. Radiologically, lesion size and filling were found to remain stable at CT follow-up. Moreover, on average 9 out of 10 patients were able to participate in sport and could return to, or remain at, their preinjury work activities.</p>\",\"PeriodicalId\":9626,\"journal\":{\"name\":\"CARTILAGE\",\"volume\":\" \",\"pages\":\"19476035251376180\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476373/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CARTILAGE\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/19476035251376180\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CARTILAGE","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19476035251376180","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Non-Operative Management for Osteochondral Lesions of the Tibial Plafond Results in Minor Improvements of Patient-Reported Outcomes: A 2-Year Prospective Follow-Up Study.
ObjectiveOsteochondral lesions of the tibial plafond (OLTP) are considered rare, and to date the treatment for these lesions has solely focused on operative management. The aim of this study was to prospectively assess the 2-year patient-reported outcomes, radiological outcomes, and adverse outcomes for the non-operative treatment of patients with a symptomatic OLTP.DesignEighteen patients with a symptomatic OLTP who underwent non-operative treatment were prospectively assessed. The primary outcome concerned the numeric rating scale (NRS) for pain during weightbearing from baseline to 2-year follow-up. Secondarily, the patient-reported outcomes (PROMs) NRS during rest, running, and stairclimbing, as well as the Foot and Ankle Outcome Score (FAOS) and short-form-36 (SF-36) questionnaires were assessed. CT scans at median 2 years (IQR: 1.5-2) follow-up were reviewed for changes in lesion volume or signs of lesion healing. Return to sports and work rates were evaluated. The conversion to surgery rate and any complications were assessed.ResultsThe NRS during weightbearing improved (non-significantly) from a median of 5 (IQR: 3-7) out of 10 at baseline to 2 (IQR: 1-6) out of 10 at 2-year follow-up, P = 0.06. The other NRS subscales, FAOS subscales, and SF-36 did not significantly improve at final follow-up. The follow-up CT-evaluation showed that lesion volume did not change (219 [IQR: 79-890] mm3) compared to baseline (226 [IQR: 79-890] mm3), P = 0.2. In 10 (77%) out of 13 cases, signs of lesion filling or no change was observed. At final follow-up, 93% (13/14) of patients returned to any level of sports, 54% (7/13) of patients returned to preinjury level of sports, and 94% (15/16) of patients returned to work. No adverse events were observed, and 1 (6%) case converted to surgery.ConclusionsNon-operative management for OLTP resulted in minor improvements of patient-reported pain and functional outcomes up to 2-year follow-up. The conversion to surgery rate was 6%. Radiologically, lesion size and filling were found to remain stable at CT follow-up. Moreover, on average 9 out of 10 patients were able to participate in sport and could return to, or remain at, their preinjury work activities.
期刊介绍：
CARTILAGE publishes articles related to the musculoskeletal system with particular attention to cartilage repair, development, function, degeneration, transplantation, and rehabilitation. The journal is a forum for the exchange of ideas for the many types of researchers and clinicians involved in cartilage biology and repair. A primary objective of CARTILAGE is to foster the cross-fertilization of the findings between clinical and basic sciences throughout the various disciplines involved in cartilage repair.
The journal publishes full length original manuscripts on all types of cartilage including articular, nasal, auricular, tracheal/bronchial, and intervertebral disc fibrocartilage. Manuscripts on clinical and laboratory research are welcome. Review articles, editorials, and letters are also encouraged. The ICRS envisages CARTILAGE as a forum for the exchange of knowledge among clinicians, scientists, patients, and researchers.
The International Cartilage Repair Society (ICRS) is dedicated to promotion, encouragement, and distribution of fundamental and applied research of cartilage in order to permit a better knowledge of function and dysfunction of articular cartilage and its repair.
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