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首页> 外文期刊>Foot and ankle international >Nonoperatively managed stage 5 osteochondral talar lesions.
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Nonoperatively managed stage 5 osteochondral talar lesions.

机译：非手术治疗的5期骨软骨距骨病变。

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Thirty-five ankles in 34 subjects with non-surgically managed stage 5 (chronic) osteochondral lesions of the talus (OLT) were reassessed an average of 38 months post diagnosis--88 months post symptom onset. The overall clinical result was rated good or excellent in 54%, fair in 17% and poor in 29%. Six patients opted for surgery--arthroscopic drilling--after a trial of one year of nonsurgical treatment and were therefore rated as poor. Tomogram or CT scans at the time of diagnosis and follow-up were compared in 25 patients. We found no significant change in lesion size and there was a poor correlation between change in lesion size and clinical outcome. X-rays performed at follow-up on 20 patients showed mild degenerative changes in 13 of 20 ankles with OLT. No correlation was found between the presence of degenerative changes and the clinical outcome. We conclude that: 1. Non-surgical management of stage 5 OLT is a viable option with little or no risk of developing significant osteoarthritis. 2. Most lesions remain radiographically stable. 3. There is a poor correlation between changes in lesion size and clinical outcome. However, the few patients with lesions which decrease significantly in size tend to do well and those with lesions which increase significantly in size do poorly. 4. The development of mild radiographic changes of OA does not correlate with clinical outcome. 5. The general course of stage 5 OLT is benign with over half of the patients improving to good or excellent results with non-surgical management. 6. Lateral lesions tend to do better than medial ones. 7. Adult onset lesions tend to do better than juvenile onset lesions.
机译：在诊断后平均38个月-症状发作后88个月，对34例非手术治疗的距骨5期（慢性）骨软骨损伤（OLT）的受试者中的35根踝关节进行了重新评估。总体临床结果评定为好或极好为54％，一般为17％，较差为29％。经过一年的非手术治疗试验后，有六名患者选择了手术-关节镜打孔-因此被定为贫困。诊断和随访时对25例患者进行了断层扫描或CT扫描。我们发现病变大小无明显变化，病变大小与临床结局之间的相关性较差。在随访中对20例患者进行的X射线检查显示，OLT导致20例踝关节中的13例出现了轻度的退行性改变。在退行性改变的存在与临床结果之间未发现相关性。我们得出以下结论：1.第5阶段OLT的非手术治疗是一种可行的选择，很少或没有发生严重骨关节炎的风险。 2.大多数病变在放射学上保持稳定。 3.病变大小的变化与临床结果之间的相关性很差。但是，只有少数几个病变明显变大的患者往往表现良好，而那些那些病变明显变大的患者则表现较差。 4. OA放射学轻度变化的发生与临床结果无关。 5. 5 OLT的一般过程是良性的，超过一半的患者通过非手术治疗可改善为良好或优异的效果。 6.外侧病变往往比内侧病变好。 7.成人发病灶往往比少年发病灶好。

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