Postoperative Management of Osteochondral Lesions of the Ankle: A Survey Among German-Speaking Foot and Ankle Surgeons.

IF 2.7 4区医学 Q1 ORTHOPEDICS CARTILAGE Pub Date : 2024-09-01 Epub Date: 2023-12-03 DOI:10.1177/19476035231213184

Aurich Matthias, Christoph Becher, Sarah Ettinger, Oliver Gottschalk, Daniel Guenther, Kajetan Klos, Marc-Daniel Ahrend, Daniel Körner, Christian Plaass, Markus Walther

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Abstract

Objective: To assess the current treatment of osteochondral lesions of the ankle (OCLA) by German-speaking foot and ankle surgeons, focusing on the management of postoperative care and rehabilitation.

Design: A questionnaire was created by a panel of 4 experienced foot and ankle surgeons on behalf of the "Clinical Tissue Regeneration" (CTR) working group of the German Society of Orthopaedics and Trauma Surgery (DGOU), and distributed electronically to members of the CTR, participants of the German Cartilage Registry (Knorpelregister DGOU©), and members of 6 German-speaking orthopedics or sports medicine societies. Results were classified depending on the consensus within the answers (agreement ≥75% "strong tendency," 50%-74% "tendency," 25%-49% "weak tendency," <25% "no tendency").

Results: A total of 60 participants returned the questionnaire. The main results are as follows: regarding the frequency of surgical procedures for OCLA, refixation of the fragment, retrograde drilling, and bone marrow stimulation with or without using a matrix were performed by at least 75% of the surgeons and was considered a strong tendency. There was a strong tendency to stabilize the ankle (76.7%) and perform corrective osteotomies (51.7%). In total, 75.5% and 75% of the surgeons performed bone marrow stimulation with and without using a matrix, respectively. Corrective osteotomy and ankle stabilization were performed in 64.5% and 65.2% cases, respectively. Most participants included published recommendations on postoperative rehabilitation and the return to sports activities in their postoperative management. The main surgical procedures were considered the most critical factor in influencing the postoperative management by 81% of the participants (strong tendency). Adjunct surgical procedures such as corrective osteotomy and stabilization of the ankle were considered important by 67.8% of the respondents (tendency).

Conclusions: The management of OCLA varies among German-speaking foot and ankle surgeons. Therefore, guidelines remain essential to standardize the management of OCLA, to achieve improved and stable results. This survey will assist clinicians and patients with rehabilitation to return to sports after treating the ankle's cartilage injury.

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踝关节骨软骨病变的术后处理:德语足和踝关节外科医生的调查。

目的:评价德语足踝外科医生治疗踝关节骨软骨病变(OCLA)的现状，重点介绍术后护理和康复管理。设计:由代表德国骨科与创伤外科学会(DGOU)“临床组织再生”(CTR)工作组的4名经验丰富的足部和踝关节外科医生组成的小组制作了一份问卷，并以电子方式分发给CTR成员、德国软骨登记处(knnorpelregister DGOU©)的参与者以及6个德语骨科或运动医学学会的成员。结果根据答案的一致性进行分类(一致性≥75%为“强倾向”，50%-74%为“倾向”，25%-49%为“弱倾向”。结果:共有60名参与者返回了问卷。主要结果如下:关于OCLA手术的频率，至少75%的外科医生进行了碎片再固定、逆行钻孔和骨髓刺激(有或没有使用基质)，并且被认为是一种强烈的趋势。踝关节稳定(76.7%)和矫正性截骨(51.7%)的倾向较强。总的来说，75.5%和75%的外科医生分别使用和不使用基质进行骨髓刺激。矫正截骨和踝关节稳定分别占64.5%和65.2%。大多数参与者在术后管理中纳入了关于术后康复和重返体育活动的已发表建议。81%的参与者认为主要手术方式是影响术后管理的最关键因素(强倾向)。67.8%的受访者(倾向)认为辅助外科手术如矫正截骨和踝关节稳定很重要。结论:在讲德语的足部和踝关节外科医生中，OCLA的处理方法各不相同。因此，指导方针对于规范OCLA的管理，实现改进和稳定的结果仍然是必不可少的。这项调查将有助于临床医生和康复患者在治疗踝关节软骨损伤后重返运动。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CARTILAGE ORTHOPEDICS-

CiteScore

6.90

自引率

7.10%

发文量

期刊介绍： CARTILAGE publishes articles related to the musculoskeletal system with particular attention to cartilage repair, development, function, degeneration, transplantation, and rehabilitation. The journal is a forum for the exchange of ideas for the many types of researchers and clinicians involved in cartilage biology and repair. A primary objective of CARTILAGE is to foster the cross-fertilization of the findings between clinical and basic sciences throughout the various disciplines involved in cartilage repair. The journal publishes full length original manuscripts on all types of cartilage including articular, nasal, auricular, tracheal/bronchial, and intervertebral disc fibrocartilage. Manuscripts on clinical and laboratory research are welcome. Review articles, editorials, and letters are also encouraged. The ICRS envisages CARTILAGE as a forum for the exchange of knowledge among clinicians, scientists, patients, and researchers. The International Cartilage Repair Society (ICRS) is dedicated to promotion, encouragement, and distribution of fundamental and applied research of cartilage in order to permit a better knowledge of function and dysfunction of articular cartilage and its repair.