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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Osteochondral lesions of the talus: clinical and functional assessment of conservative vs scope treatment
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Osteochondral lesions of the talus: clinical and functional assessment of conservative vs scope treatment

机译：距骨的骨软骨损伤：保守治疗与范围治疗的临床和功能评估

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Introduction: Osteochondral injuries involving the ankle joint are unusual (incidence of 0.09% according to Berndt and Harty), third in frequency after knee and elbow location. They are described as a cause of chronic pain after ankle sprains in the active population (thought to occur in 2-6% of sprains). MRI is the gold standard diagnostic method. Therapeutic strategies include both conservative and surgical treatment. The aim of our study was to evaluate the clinical and functional outcome of patients with osteochondral lesions of the talus. Materials and Methods: We retrospectively reviewed 20 patients with osteochondral lesions of the talus treated in our department between January 2007 and December 2012. Sixty per cent were male with an average age of 42 years.Eleven patients were treated conservatively, one of them had clear surgical indication (LOC G III, as classified by Ferkel and Sgaglione) but refused to perform the procedure. Nine patients underwent arthroscopic surgery (debridement and microfracture), one of the procedures was a review of an arthroscopy performed in another service. No open surgery was performed.Clinical and functional evaluation was performed using the AOFAS score, Freiburg and VAS Score System. Results: Non-surgical treatment group had a pretreatment average AOFAS score of 58, which improved to 74.8 points; a Freiburg Score System that ranged from 65 to 79.3 points and a VAS average of 5,4. AOFAS surgical treatment group improved from 54.3 to 84.8 points, Freiburg Score System ranged from 60.6 to 81.4 points and VAS average was of 5,8. Discussion: It is difficult to compare our results with other series of patients, because we made a comparison between conservative versus artrhoscopic treatment, while other authors show results obtained when performing certain surgical techniqueAlthough surgical treatment has better results, we agree with the literature that conservative treatment presents acceptable results and should always be considered as the first option.
机译：简介：涉及踝关节的骨软骨损伤很罕见（根据Berndt和Harty的说法，发生率为0.09％），在膝盖和肘部定位之后的发生频率为第三位。他们被描述为活动人群的踝关节扭伤后慢性疼痛的原因（被认为是扭伤的2-6％）。 MRI是金标准诊断方法。治疗策略包括保守治疗和手术治疗。我们研究的目的是评估距骨骨软骨病患者的临床和功能结局。材料与方法：我们回顾性回顾了2007年1月至2012年12月在我科接受治疗的20例距骨骨软骨病患者。男性的60％，平均年龄42岁。保守治疗11例，其中1例病情明确。手术指征（Ferkel和Sgaglione分类的LOC G III），但拒绝执行该手术。 9名患者接受了关节镜手术（清创术和微骨折），其中一项程序是对另一项服务中进行的关节镜检查进行复查。没有进行开放手术。使用AOFAS评分，弗莱堡和VAS评分系统进行临床和功能评估。结果：非手术治疗组的平均AOFAS评分为58，改善了74.8分。 Freiburg评分系统的得分介于65到79.3分之间，VAS平均值为5.4。 AOFAS外科治疗组从54.3分提高到84.8分，弗莱堡评分系统从60.6分提高到81.4分，VAS平均得分为5,8。讨论：很难将我们的结果与其他系列患者进行比较，因为我们在保守治疗和关节镜治疗之间进行了比较，而其他作者则显示了在执行某些外科手术技术时获得的结果尽管外科治疗效果更好，但我们与文献一致治疗呈现可接受的结果，应始终被视为首选。

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