Detaillierte Beitrags-Information

Zurück zur Liste

Beitragstitel Evidence for surgical treatment of osteochondral lesions in the talus. A systematic review
Beitragscode P40
  1. Fabienne Inglin Vortragender
  2. Fabian Götz Krause Inselspital - Universitätsspital Bern
  3. Helen Anwander Inselspital Bern
Präsentationsform Poster
  • A06 - Fuss
Abstract Introduction
The therapy of osteochondral lesion is surgically challenging and various techniques are available. The most used methods are : bone marrow stimulation, Cartilage implantation and Bone/Cartilage-Transplantation.
The goal of this systematic review is to investigate and understand the effectiveness and indications of the surgical treatment options.

This work is a systematic review from studies which were publicated between 2000 and 2020. Inclusion criterias were osteochondral lesions which have been surgically treated, a minimal follow up of 24 months and a minimum of 10 patients which have been at least 16 years of age. The level of evidence was between I and IV.

This study include 45 studies; 20 Bone marrow stimulation (18 BMS & 5 AMIC), 9 Cartilageimplantation (6 ACI & 2 MACI) and 17 transplantations (8 OATS, 5 autograft & 4 allograft).
The study shows an inverse correlation between the initial American Orthopaedic Foot & Ankle Society (AOFAS) Score an the improvement of the value score (R= -0.849, P < .001). However there was a positive correlation from the inital AOFAS Score and the outcome-Score (R= 0.421, P= .008). Furthermore we came to the conclusion that the preoperative size of the cartilage lesion shows no correlation to the AOFAS Score at time after surgery.

The bone marrow stimulation was the most published surgical technique. It was particulary used in small (medium size lesion < 90mm2) and most primary lesions. The widest lesion (> 200 mm2) in the youngest patient group (medium age: 32 years) have been treated with autologous chondrocyte implantation.
Patient groups with a wide and very symptomatic lesion could benefit the most with an operative therapy of the ostechondral lesion in the talus.
However, due to the heterogenity of the studies, including the different baselines, a comparison of the results between the different surgical techiques was not possible.