目的:研究伴随的软骨下骨囊肿(SBCs)对关节镜下骨髓刺激(BMS)治疗距骨软骨病变(OLTs)小于100mm2后预后的影响,并进一步评估囊性OLT面积之间的相关性。深度,或体积和术后结果。
方法:我们回顾性分析了2017年4月至2020年5月期间接受BMS治疗的连续OLT(<100mm2)患者,随访时间最少24个月。病变面积,深度,在术前磁共振成像上采集体积。视觉模拟量表(VAS),美国骨科足踝协会,卡尔松-彼得森,Tegner,足和踝关节能力测量-日常生活活动(FAAM-ADL)和运动(FAAM-SP)评分在术前和最新随访时进行评估。此外,我们采用一般线性模型(GLM)和Pearson相关分析(PCA)来研究伴随囊肿对术后结果的影响.
结果:82例患者平均随访39.22±12.53个月,分为非囊肿组(n=45;39.91±13.03个月)和囊肿组(n=37;38.37±12.02个月)。非囊肿组和囊肿组OLT面积差异无统计学意义(46.98±19.95mm2vs.56.08±22.92mm2;P=.093),但囊肿组显示出明显更大的深度(6.06±1.99mmvs.3.96±1.44mm;P=.000)和体积(248.26±156.81mm3vs.134.58±89.68mm3;P=.002)。无囊肿组VAS疼痛明显改善,卡尔松-彼得森,Tegner,而FAAM评分优于囊肿组(P<0.05)。GLM表明SBC对VAS疼痛和Tegner评分有负面影响(P<0.05)。对于有囊肿的OLT,PCA显示,面积为90.91mm2,深度为7.56mm,体积428.13mm3是与不良结局相关的潜在截止值.
结论:伴随的SBCs对BMS后OLT的预后产生负面影响。对于有囊肿的OLT,面积为90.91mm2,深度为7.56mm,体积428.13mm3是与BMS后不良结局相关的潜在截止值。
方法:三级,回顾性比较研究。
To study the effects of concomitant subchondral bone cysts (SBCs) on prognosis after arthroscopic bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLTs) less than 100 mm2 and to further assess the correlation between cystic OLT area, depth, or volume and postoperative outcomes.
We retrospectively analyzed consecutive patients with OLTs (<100 mm2) who received BMS between April 2017 and May 2020 with a minimum follow-up of 24 months. Lesion area, depth, and volume were collected on preoperative magnetic resonance imaging. Visual analog scale (VAS), American Orthopedic Foot and Ankle Society, Karlsson-Peterson, Tegner, Foot and Ankle Ability Measure (FAAM)-Activities of Daily Life and Sports scores were assessed before surgery and at the latest follow-up. Additionally, a general linear model (GLM) and a Pearson correlation analysis (PCA) were performed to investigate the effects of concomitant cysts on postoperative results.
Eighty-two patients with a mean follow-up of 39.22 ± 12.53 months were divided into non-cyst (n = 45; 39.91 ± 13.03 months) and cyst (n = 37; 38.37 ± 12.02 months) groups. There was no significant difference in the OLT area between the non-cyst and cyst groups (46.98 ± 19.95 mm2 vs 56.08 ± 22.92 mm2; P = .093), but the cyst group showed significantly greater depth (6.06 ± 1.99 mm vs 3.96 ± 1.44 mm; P = .000) and volume (248.26 ± 156.81 mm3 vs 134.58 ± 89.68 mm3; P = .002). The non-cyst group showed significantly more improvement in VAS pain, Karlsson-Peterson, Tegner, and FAAM scores than the cyst group (P < .05). The GLM indicated that SBCs negatively affected VAS pain and Tegner scores (P < .05). For OLTs with cysts, the PCA showed that an area of 90.91 mm2, depth of 7.56 mm, and volume of 428.13 mm3 were potential cutoff values associated with poor outcomes.
The concomitant SBCs negatively affected the prognosis of OLTs after BMS. For OLTs with cysts, an area of 90.91 mm2, depth of 7.56 mm, and volume of 428.13 mm3 were the potential cutoff values associated with poor outcomes after BMS.
Level III, retrospective comparative study.