Abstract：
OBJECTIVE: To compare cartilage quality after different surgical interventions for osteochondral lesions of the talus (OLT), evaluated by second-look arthroscopy. Secondary aims were to report concomitant diagnoses, and to correlate cartilage quality with clinical and radiological outcomes. This review hypothesizes that the cartilage repair after bone marrow stimulation (BMS) is inferior to the other available treatment options.
METHODS: PROSPERO ID: CRD42022311489. Studies were retrieved through PubMed, EMBASE (Ovid), and Cochrane Library. Studies were included if they reported cartilage quality after second-look investigation after surgical treatment of OLT. The primary outcome measure was the cartilage quality success and failure rates (%) per surgical intervention group. Correlations between the cartilage quality and clinical or radiological outcomes were calculated.
RESULTS: Twenty-nine studies were included, comprising 586 ankles that had undergone second-look arthroscopy on average 16 months after initial surgery. The success rate for BMS was 57% (95% confidence interval [CI] = 48%-65%), for fixation (FIX) 86% (95% CI = 70%-94%), for osteo(chondral) transplantation (OCT) 91% (95% CI = 80%-96%), for cartilage implementation techniques (CITs) 80% (95% CI = 69%-88%), and for retrograde drilling 100% (95% CI = 66%-100%). The success rate of BMS was significantly lower than FIX, OCT, and CIT (P < 0.01). There were no significant differences between other treatment groups. A moderate positive significant correlation between the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score and the International Cartilage Repair Society score (ICRS) was found (ρ = 0.51, P < 0.001).
CONCLUSIONS: Successful restoration of cartilage quality was found in the majority of surgically treated OLTs. However, BMS yields inferior cartilage quality compared with FIX, OCT, and CIT. Study Design. Systematic review and meta-analysis. Level of evidence. Level IV, systematic review and meta-analysis.
METHODS: PROSPERO ID: CRD42022311489. Studies were retrieved through PubMed, EMBASE (Ovid), and Cochrane Library. Studies were included if they reported cartilage quality after second-look investigation after surgical treatment of OLT. The primary outcome measure was the cartilage quality success and failure rates (%) per surgical intervention group. Correlations between the cartilage quality and clinical or radiological outcomes were calculated.
RESULTS: Twenty-nine studies were included, comprising 586 ankles that had undergone second-look arthroscopy on average 16 months after initial surgery. The success rate for BMS was 57% (95% confidence interval [CI] = 48%-65%), for fixation (FIX) 86% (95% CI = 70%-94%), for osteo(chondral) transplantation (OCT) 91% (95% CI = 80%-96%), for cartilage implementation techniques (CITs) 80% (95% CI = 69%-88%), and for retrograde drilling 100% (95% CI = 66%-100%). The success rate of BMS was significantly lower than FIX, OCT, and CIT (P < 0.01). There were no significant differences between other treatment groups. A moderate positive significant correlation between the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score and the International Cartilage Repair Society score (ICRS) was found (ρ = 0.51, P < 0.001).
CONCLUSIONS: Successful restoration of cartilage quality was found in the majority of surgically treated OLTs. However, BMS yields inferior cartilage quality compared with FIX, OCT, and CIT. Study Design. Systematic review and meta-analysis. Level of evidence. Level IV, systematic review and meta-analysis.
摘要：
目的：比较距骨软骨病（OLT）不同手术干预后的软骨质量，通过二次关节镜评估。次要目的是报告伴随的诊断，并将软骨质量与临床和放射学结果相关联。这篇评论假设骨髓刺激（BMS）后的软骨修复不如其他可用的治疗方案。
方法：PROSPEROID：CRD42022311489。研究是通过PubMed检索的，EMBASE(Ovid),科克伦图书馆如果他们报告了OLT手术治疗后的第二次调查后的软骨质量，则包括研究。主要结果指标是每个手术干预组的软骨质量成功率和失败率（％）。计算软骨质量与临床或放射学结果之间的相关性。
结果：纳入了29项研究，包括586个脚踝，平均在初次手术后16个月接受了第二次关节镜检查。BMS的成功率为57％（95％置信区间[CI]=48％-65％），固定（FIX）86%（95%CI=70%-94%），骨（软骨）移植（OCT）91%（95%CI=80%-96%），软骨实施技术(CITs)80%(95%CI=69%-88%)，逆行钻孔100%(95%CI=66%-100%)。BMS的成功率明显低于FIX，OCT,和CIT(P<0.01)。其他治疗组之间没有显著差异。软骨修复组织的磁共振观察（MOCART）评分与国际软骨修复学会评分（ICRS）之间存在中度正相关（ρ=0.51，P<0.001）。
结论：在大多数手术治疗的OLT中发现了成功的软骨质量恢复。然而,与FIX相比，BMS的软骨质量较差，OCT,和CIT.研究设计。系统评价和荟萃分析。证据水平。四级,系统评价和荟萃分析。
方法：PROSPEROID：CRD42022311489。研究是通过PubMed检索的，EMBASE(Ovid),科克伦图书馆如果他们报告了OLT手术治疗后的第二次调查后的软骨质量，则包括研究。主要结果指标是每个手术干预组的软骨质量成功率和失败率（％）。计算软骨质量与临床或放射学结果之间的相关性。
结果：纳入了29项研究，包括586个脚踝，平均在初次手术后16个月接受了第二次关节镜检查。BMS的成功率为57％（95％置信区间[CI]=48％-65％），固定（FIX）86%（95%CI=70%-94%），骨（软骨）移植（OCT）91%（95%CI=80%-96%），软骨实施技术(CITs)80%(95%CI=69%-88%)，逆行钻孔100%(95%CI=66%-100%)。BMS的成功率明显低于FIX，OCT,和CIT(P<0.01)。其他治疗组之间没有显著差异。软骨修复组织的磁共振观察（MOCART）评分与国际软骨修复学会评分（ICRS）之间存在中度正相关（ρ=0.51，P<0.001）。
结论：在大多数手术治疗的OLT中发现了成功的软骨质量恢复。然而,与FIX相比，BMS的软骨质量较差，OCT,和CIT.研究设计。系统评价和荟萃分析。证据水平。四级,系统评价和荟萃分析。
