PDF(Pubmed)
Abstract：
Osteochondral lesion of the talus (OLT) is a localized cartilage and subchondral bone injury of the talus trochlea. OLT is caused by trauma and other reasons, including osteochondritis dissecans of the talus (OCD) and talus osteochondral tangential fracture. OLT can develop from being asymptomatic to subchondral bone cysts accompanied by deep ankle pain. OLT tends to occur on the medial and lateral sides of the talar vault. OLT seriously affects the patients\' life and work and may even lead to disability. Herein, we reviewed advances in the treatment of OLT and the strengths and weaknesses of various treatments. Different treatment methods, including conservative treatments and surgical treatments, can be adopted according to the different subtypes or clinical symptoms of OLT. Conservative treatments mostly relieve symptoms in the short term and only slow down the disease. In recent years, it has been discovered that platelet-rich plasma injection, microfracture, periosteal bone grafting, talar cartilage transplantation, allograft bone transplantation, reverse drilling under robotic navigation, and other methods can achieve considerable benefits when each of these treatment methods is applied. Furthermore, microfracture combined with platelet-rich plasma injections, microfracture combined with cartilage transplantation, and various other treatment methods combined with anterior talofibular ligament repair have all led to good treatment outcomes.
摘要：
距骨软骨损伤（OLT）是距骨滑车的局部软骨和软骨下骨损伤。OLT是由外伤等原因引起的,包括距骨剥脱性骨软骨炎（OCD）和距骨软骨切向骨折。OLT可以从无症状发展为伴有深踝关节疼痛的软骨下骨囊肿。OLT往往发生在距骨穹窿的内侧和外侧。OLT严重影响患者的生活和工作，甚至可能导致残疾。在这里，我们回顾了OLT的治疗进展以及各种治疗方法的优缺点。不同的治疗方法,包括保守治疗和手术治疗，可根据OLT的不同亚型或临床症状采用。保守治疗大多在短期内缓解症状，只能减缓疾病。近年来,已经发现，富含血小板的血浆注射，微骨折,骨膜植骨，距骨软骨移植,同种异体骨移植,机器人导航下的反向钻孔，当应用这些治疗方法中的每一种时,和其他方法可以获得相当大的益处。此外，微骨折联合富血小板血浆注射，微骨折联合软骨移植，其他各种治疗方法联合前腓骨韧带修复均取得了良好的治疗效果。
