Abstract：
OBJECTIVE: A treatment-specific rehabilitation protocol and well-defined return-to-play criteria guide clinical decision-making on return to normal function, activity, sports and performance after surgical treatment for osteochondral lesion of the talus (OLT). The optimal rehabilitation protocols in the current literature remain unclear. The purpose of this study was to explore the existing literature on rehabilitation protocols from the early postoperative phase to return to sport onwards after different types of surgical treatment of OLTs.
METHODS: PubMed, Embase, CDSR, DARE and Central were searched systematically from inception to February 2023 according to the PRISMA 2020 guidelines. All clinical studies with a description of postoperative rehabilitation criteria after surgical treatment of OLTs were included. The primary outcome of this study is the extent of reportage for each rehabilitation parameter expressed in percentage. The secondary outcome is the reported median time for each parameter in rehabilitation protocols for all different treatment modalities (type of surgery). The median time, expressed as number of weeks, for each parameter was compared between different types of surgery.
RESULTS: A total of 227 articles were included reporting on 255 different rehabilitation protocols from seven different types of surgery. Weight-bearing instructions were reported in 84%-100% and the use of a cast or walker was prescribed in 27%-100%. Range of motion exercises were described in 54%-100% whereas physical therapy was advised in 21%-67% of the protocols. Any advice on return to sport was described in 0%-67% protocols. A nonparametric analysis of variance showed significant differences between the different surgical treatment modalities for the following parameters between the treatment groups: time to full weight-bearing (p < 0.0003) and return to high impact level of sports (p < 0.0003). Subjective or objective criteria for progression during rehabilitation were reported in only 24% of the studies.
CONCLUSIONS: An in-depth exploration of the current literature showed substantial variation in postoperative rehabilitation guidelines with an associated underreporting of the most important rehabilitation parameters in postoperative protocols after surgical treatment of OLTs. Furthermore, nearly all rehabilitation protocols were constructed according to a time-based approach. Only one out of four reported either objective or subjective criteria.
METHODS: Level IV, systematic review.
METHODS: PubMed, Embase, CDSR, DARE and Central were searched systematically from inception to February 2023 according to the PRISMA 2020 guidelines. All clinical studies with a description of postoperative rehabilitation criteria after surgical treatment of OLTs were included. The primary outcome of this study is the extent of reportage for each rehabilitation parameter expressed in percentage. The secondary outcome is the reported median time for each parameter in rehabilitation protocols for all different treatment modalities (type of surgery). The median time, expressed as number of weeks, for each parameter was compared between different types of surgery.
RESULTS: A total of 227 articles were included reporting on 255 different rehabilitation protocols from seven different types of surgery. Weight-bearing instructions were reported in 84%-100% and the use of a cast or walker was prescribed in 27%-100%. Range of motion exercises were described in 54%-100% whereas physical therapy was advised in 21%-67% of the protocols. Any advice on return to sport was described in 0%-67% protocols. A nonparametric analysis of variance showed significant differences between the different surgical treatment modalities for the following parameters between the treatment groups: time to full weight-bearing (p < 0.0003) and return to high impact level of sports (p < 0.0003). Subjective or objective criteria for progression during rehabilitation were reported in only 24% of the studies.
CONCLUSIONS: An in-depth exploration of the current literature showed substantial variation in postoperative rehabilitation guidelines with an associated underreporting of the most important rehabilitation parameters in postoperative protocols after surgical treatment of OLTs. Furthermore, nearly all rehabilitation protocols were constructed according to a time-based approach. Only one out of four reported either objective or subjective criteria.
METHODS: Level IV, systematic review.
摘要：
目的：针对特定治疗的康复方案和明确的重返比赛标准指导临床恢复正常功能的决策，活动,距骨软骨损伤（OLT）手术治疗后的运动和表现。目前文献中的最佳康复方案仍不清楚。这项研究的目的是探索现有的文献，从术后早期阶段到不同类型的OLT手术治疗后恢复运动。
方法：PubMed，Embase,CDSR,根据PRISMA2020指南，从成立到2023年2月，对DARE和Central进行了系统搜索。包括所有描述OLT手术治疗后术后康复标准的临床研究。这项研究的主要结果是以百分比表示的每个康复参数的报告文学程度。次要结果是所有不同治疗方式（手术类型）的康复方案中每个参数的报告中位时间。中位数时间，以周数表示，在不同类型的手术之间比较了每个参数.
结果：共纳入227篇文章，报告了来自7种不同类型手术的255种不同康复方案。报道了84％-100％的负重说明，并规定了27％-100％的演员或助行器的使用。在54％-100％中描述了运动范围，而在21％-67％的方案中建议进行物理治疗。在0％-67％的协议中描述了有关重返运动的任何建议。非参数方差分析显示，治疗组之间不同手术治疗方式在以下参数方面存在显着差异：完全负重时间（p<0.0003）和恢复到高影响运动水平（p<0.0003）。只有24％的研究报告了康复过程中进展的主观或客观标准。
结论：对现有文献的深入探索表明，术后康复指南存在很大差异，与手术治疗OLT术后方案中最重要的康复参数存在相关漏报。此外，几乎所有的康复方案都是根据基于时间的方法构建的.只有四分之一的人报告了客观或主观的标准。
方法：四级，系统回顾。
方法：PubMed，Embase,CDSR,根据PRISMA2020指南，从成立到2023年2月，对DARE和Central进行了系统搜索。包括所有描述OLT手术治疗后术后康复标准的临床研究。这项研究的主要结果是以百分比表示的每个康复参数的报告文学程度。次要结果是所有不同治疗方式（手术类型）的康复方案中每个参数的报告中位时间。中位数时间，以周数表示，在不同类型的手术之间比较了每个参数.
结果：共纳入227篇文章，报告了来自7种不同类型手术的255种不同康复方案。报道了84％-100％的负重说明，并规定了27％-100％的演员或助行器的使用。在54％-100％中描述了运动范围，而在21％-67％的方案中建议进行物理治疗。在0％-67％的协议中描述了有关重返运动的任何建议。非参数方差分析显示，治疗组之间不同手术治疗方式在以下参数方面存在显着差异：完全负重时间（p<0.0003）和恢复到高影响运动水平（p<0.0003）。只有24％的研究报告了康复过程中进展的主观或客观标准。
结论：对现有文献的深入探索表明，术后康复指南存在很大差异，与手术治疗OLT术后方案中最重要的康复参数存在相关漏报。此外，几乎所有的康复方案都是根据基于时间的方法构建的.只有四分之一的人报告了客观或主观的标准。
方法：四级，系统回顾。
