Abstract：
UNASSIGNED: Osteochondral lesions of the talus (OLTs) are among the common sports-related injuries. However, there are few reports on the return to sports after OLT surgery in skeletally immature children. This study was performed to evaluate the return to sports after microfracture for OLTs in skeletally immature children.
UNASSIGNED: This study involved 17 ankles of 16 patients (mean age, 13.2 years; range, 10-16 years) with open tibial epiphyses on magnetic resonance imaging (MRI) who underwent microfracture for OLTs <10 mm in diameter and confirmation of lesion instability under arthroscopy. Nine of 17 ankles had additional lateral ankle ligament stabilization. All patients were participating in some form of sports. The Japanese Society for Surgery of the Foot (JSSF) score, Ankle Activity Score (AAS), return to sports rate, lesion size, grade of subchondral bone marrow edema, and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score on MRI were evaluated after microfracture. The mean postoperative follow-up period was 53.5 months.
UNASSIGNED: The mean JSSF score significantly improved from 76.1 points preoperatively to 94.9 points at the final follow-up (P < .01). The mean AAS showed no change from preoperative state to final follow-up. The return to sports rate was 100%. The lesion size significantly decreased from 76.3 to 56.7 mm2 in area (P = .02) and from 283.2 to 185.6 mm3 in volume (P = .05). The bone marrow edema grade decreased in 8 of 17 ankles. The total MOCART score showed a significant improvement from 6 months to 1 year postoperatively (P = .05).
UNASSIGNED: All skeletally immature children who underwent microfracture for OLTs in this study were able to return to sports activity and showed improvements in clinical scores and MRI parameters. Microfracture may be considered an effective first-line treatment for OLTs <10 mm in diameter in skeletally immature athletes.
UNASSIGNED: Level IV, retrospective case-control study.
UNASSIGNED: This study involved 17 ankles of 16 patients (mean age, 13.2 years; range, 10-16 years) with open tibial epiphyses on magnetic resonance imaging (MRI) who underwent microfracture for OLTs <10 mm in diameter and confirmation of lesion instability under arthroscopy. Nine of 17 ankles had additional lateral ankle ligament stabilization. All patients were participating in some form of sports. The Japanese Society for Surgery of the Foot (JSSF) score, Ankle Activity Score (AAS), return to sports rate, lesion size, grade of subchondral bone marrow edema, and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score on MRI were evaluated after microfracture. The mean postoperative follow-up period was 53.5 months.
UNASSIGNED: The mean JSSF score significantly improved from 76.1 points preoperatively to 94.9 points at the final follow-up (P < .01). The mean AAS showed no change from preoperative state to final follow-up. The return to sports rate was 100%. The lesion size significantly decreased from 76.3 to 56.7 mm2 in area (P = .02) and from 283.2 to 185.6 mm3 in volume (P = .05). The bone marrow edema grade decreased in 8 of 17 ankles. The total MOCART score showed a significant improvement from 6 months to 1 year postoperatively (P = .05).
UNASSIGNED: All skeletally immature children who underwent microfracture for OLTs in this study were able to return to sports activity and showed improvements in clinical scores and MRI parameters. Microfracture may be considered an effective first-line treatment for OLTs <10 mm in diameter in skeletally immature athletes.
UNASSIGNED: Level IV, retrospective case-control study.
摘要：
■距骨软骨损伤（OLTs）是常见的运动相关损伤。然而,很少有关于骨骼未成熟儿童OLT手术后恢复运动的报道。进行这项研究是为了评估骨骼未成熟儿童OLT微骨折后恢复运动的情况。
■这项研究涉及16例患者的17个脚踝（平均年龄，13.2年；范围，10-16岁）在磁共振成像（MRI）上有开放性胫骨骨phy，因直径<10mm的OLT进行了微骨折，并在关节镜下确认了病变的不稳定性。17个脚踝中有9个有额外的踝关节外侧韧带稳定。所有患者都参加了某种形式的运动。日本足外科学会（JSSF）评分，踝关节活动评分(AAS),回到运动率，病变大小,软骨下骨髓水肿分级,微骨折后评估软骨修复组织（MOCART）MRI评分。术后平均随访53.5个月。
■平均JSSF评分从术前的76.1分显着提高到最终随访时的94.9分（P<0.01）。从术前状态到最终随访，平均AAS没有变化。体育回报率为100％。病变面积从76.3mm2显著减小至56.7mm2(P=.02),体积从283.2mm3减小至185.6mm3(P=.05)。17例踝关节中8例骨髓水肿分级降低。MOCART总分从术后6个月到1年有显著改善（P=0.05）。
■在这项研究中，所有接受过微骨折的骨骼发育不成熟儿童都能够恢复体育活动，并显示出临床评分和MRI参数的改善。对于骨骼未成熟的运动员，微骨折可能被认为是直径<10mm的OLT的有效一线治疗方法。
■四级，回顾性病例对照研究。
■这项研究涉及16例患者的17个脚踝（平均年龄，13.2年；范围，10-16岁）在磁共振成像（MRI）上有开放性胫骨骨phy，因直径<10mm的OLT进行了微骨折，并在关节镜下确认了病变的不稳定性。17个脚踝中有9个有额外的踝关节外侧韧带稳定。所有患者都参加了某种形式的运动。日本足外科学会（JSSF）评分，踝关节活动评分(AAS),回到运动率，病变大小,软骨下骨髓水肿分级,微骨折后评估软骨修复组织（MOCART）MRI评分。术后平均随访53.5个月。
■平均JSSF评分从术前的76.1分显着提高到最终随访时的94.9分（P<0.01）。从术前状态到最终随访，平均AAS没有变化。体育回报率为100％。病变面积从76.3mm2显著减小至56.7mm2(P=.02),体积从283.2mm3减小至185.6mm3(P=.05)。17例踝关节中8例骨髓水肿分级降低。MOCART总分从术后6个月到1年有显著改善（P=0.05）。
■在这项研究中，所有接受过微骨折的骨骼发育不成熟儿童都能够恢复体育活动，并显示出临床评分和MRI参数的改善。对于骨骼未成熟的运动员，微骨折可能被认为是直径<10mm的OLT的有效一线治疗方法。
■四级，回顾性病例对照研究。
