Abstract：
Osteochondral lesions of the talus (OLT) are common injuries requiring surgery. Arthroscopic microfracture treatment is effective and acceptable. Although the concept of postoperative rehabilitation is continuously being updated, the choice between early weightbearing (EWB) versus delayed weightbearing (DWB) following microfracture is still not settled. A meta-analysis and systematic review was performed to compare the rehabilitation effect of 2 different weightbearing protocols following microfracture. Five databases were searched for relevant studies, and full-text articles comparing EWB and DWB were reviewed. Review Manager 5.3 software was used to summarize the results of the included studies. Two reviewers independently filtered the studies, assessed quality, extracted data, and estimated the risk of bias. The pain score and functional assessment of the ankle were selected as the endpoints. The mean difference was calculated as the summary statistic for continuous data. Then, visual analog scale and American Orthopedic Foot and Ankle Society scale scores were collected and pooled. Five randomized controlled trials including 283 patients were identified for this study, revealing that there was no significant difference in pain scores between EWB and DWB following microfracture 3 months, 6 months, 12 months, and 24 months postoperatively. Function assessment showed similar results. Comprehensive analysis of current evidence still suggests that EWB and DWB after microfracture of OLT produce comparable clinical outcomes in terms of pain and functional activity. Therefore, EWB is recommended to shorten the length of time before returning to work or sports after microfracture of OLT.
摘要：
距骨软骨损伤(OLT)是需要手术的常见损伤。关节镜下微骨折治疗是有效和可接受的。虽然术后康复的观念在不断更新,早期负重(EWB)与微骨折后延迟负重(DWB)之间的选择仍未确定.进行了荟萃分析和系统评价，以比较微骨折后两种不同的负重方案的康复效果。搜索了五个数据库进行相关研究，并对比较EWB和DWB的全文文章进行了综述。使用ReviewManager5.3软件对纳入研究的结果进行总结。两名审稿人独立过滤了这些研究，评估质量，提取的数据，并估计了偏差的风险。选择踝关节的疼痛评分和功能评估作为终点。平均差异计算为连续数据的汇总统计量。然后，收集并汇总视觉模拟量表和美国骨科足踝协会量表评分.这项研究确定了五项随机对照试验，包括283例患者，发现微骨折3个月后，EWB和DWB之间的疼痛评分没有显着差异，6个月,12个月,术后24个月。功能评估结果相似。对当前证据的综合分析仍然表明，OLT微骨折后的EWB和DWB在疼痛和功能活动方面产生了可比的临床结果。因此,建议EWB缩短OLT微骨折后返回工作或运动前的时间。
