Abstract：
BACKGROUND: Osteochondral lesions of the talar dome (OLTD) are most often found in patients for whom the return to sports activities is the main issue. Two types of surgery have been distinguished at present, bone marrow stimulation techniques and mosaicplasty techniques. The size of the lesion indicating the need for bone marrow stimulation as the required surgical procedure has recently been decreased (<1cm). The main objective of this study was therefore to evaluate the return to sport after OLTD surgery. Our hypothesis is that surgery of osteochondral lesions of the talar dome allows the resumption of sports activities in the majority of cases.
METHODS: This multicenter prospective study was conducted across 10 French centers specializing in foot and ankle surgery. All patients aged 18 to 65 with symptomatic OLTD resistant to thorough medical treatment for at least 6 months, justifying surgery, were included from June 2018 to September 2019. In addition to the usual demographic data, the practice of sport and level (professional, competitive, leisure) were systematically investigated preoperatively. A common protocol for surgical management and postoperative follow-up had previously been established according to the arthrographic stage of the lesion. The most recent recommendations based on size, but also depth, were taken into account. The primary endpoint was return to sport.
RESULTS: A final functional evaluation with the AOFAS (American Orthopedic Foot & Ankle Society) score was performed at a minimum of 12 months. Of 58 sports patients, 70.6% returned to sport (41/58) with an average delay of 4.3 months. A high AOFAS functional score (p=0.02) and a stage 1 lesion (p=0.006) were the only preoperative criteria significantly associated with a return to sport. No other factor was predictive of a return to sport.
CONCLUSIONS: Our prospective study shows that 70.6% of sports patients returned to sport after OLTD surgery according to a surgical protocol and standardized follow-up.
METHODS: II.
METHODS: This multicenter prospective study was conducted across 10 French centers specializing in foot and ankle surgery. All patients aged 18 to 65 with symptomatic OLTD resistant to thorough medical treatment for at least 6 months, justifying surgery, were included from June 2018 to September 2019. In addition to the usual demographic data, the practice of sport and level (professional, competitive, leisure) were systematically investigated preoperatively. A common protocol for surgical management and postoperative follow-up had previously been established according to the arthrographic stage of the lesion. The most recent recommendations based on size, but also depth, were taken into account. The primary endpoint was return to sport.
RESULTS: A final functional evaluation with the AOFAS (American Orthopedic Foot & Ankle Society) score was performed at a minimum of 12 months. Of 58 sports patients, 70.6% returned to sport (41/58) with an average delay of 4.3 months. A high AOFAS functional score (p=0.02) and a stage 1 lesion (p=0.006) were the only preoperative criteria significantly associated with a return to sport. No other factor was predictive of a return to sport.
CONCLUSIONS: Our prospective study shows that 70.6% of sports patients returned to sport after OLTD surgery according to a surgical protocol and standardized follow-up.
METHODS: II.
摘要：
距骨穹顶（OLTD）的骨软骨病最常见于恢复体育活动是主要问题的患者。目前已经区分了两种手术类型,骨髓刺激技术和镶嵌成形技术。表明需要进行骨髓刺激作为所需外科手术的病变的大小最近已经减小(<1cm)。因此，这项研究的主要目的是评估OLTD手术后恢复运动的情况。我们的假设是，距骨圆顶骨软骨病变的手术可以在大多数情况下恢复体育活动。
方法：这项多中心前瞻性研究是在10个专门从事足踝手术的法国中心进行的。所有年龄在18至65岁的有症状的OLTD患者对彻底的药物治疗至少6个月耐药，为手术辩护，包括2018年6月至2019年9月。除了通常的人口统计数据，体育实践和水平(专业，竞争性,休闲)进行了术前系统调查。先前已根据病变的关节造影阶段建立了手术管理和术后随访的通用方案。根据大小的最新建议，还有深度，被考虑在内。主要终点是恢复运动。
结果：在至少12个月时进行了AOFAS（美国骨科足踝协会）评分的最终功能评估。
结果：在58名运动患者中，70.6%恢复运动（41/58），平均延迟4.3个月。高AOFAS功能评分（p=0.02）和1期病变（p=0.006）是唯一与恢复运动显着相关的术前标准。没有其他因素可以预测重返体育运动。
结论：我们的前瞻性研究表明，根据手术方案和标准化随访，70.6%的运动患者在OLTD手术后恢复运动。
方法：II.
方法：这项多中心前瞻性研究是在10个专门从事足踝手术的法国中心进行的。所有年龄在18至65岁的有症状的OLTD患者对彻底的药物治疗至少6个月耐药，为手术辩护，包括2018年6月至2019年9月。除了通常的人口统计数据，体育实践和水平(专业，竞争性,休闲)进行了术前系统调查。先前已根据病变的关节造影阶段建立了手术管理和术后随访的通用方案。根据大小的最新建议，还有深度，被考虑在内。主要终点是恢复运动。
结果：在至少12个月时进行了AOFAS（美国骨科足踝协会）评分的最终功能评估。
结果：在58名运动患者中，70.6%恢复运动（41/58），平均延迟4.3个月。高AOFAS功能评分（p=0.02）和1期病变（p=0.006）是唯一与恢复运动显着相关的术前标准。没有其他因素可以预测重返体育运动。
结论：我们的前瞻性研究表明，根据手术方案和标准化随访，70.6%的运动患者在OLTD手术后恢复运动。
方法：II.
