Kevin A Schafer, Brian M Cusworth, Gregory S Kazarian, Jonathon D Backus, Sandra E Klein, Jeffrey E Johnson, Jeremy J McCormick
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引用次数: 0
Abstract
Background: The management of symptomatic osteochondral lesions of the talus (OLTs) previously treated with arthroscopy is controversial. Minimal data exist on the role for repeat arthroscopy. Here, we describe our experience with repeat arthroscopy and microfracture for symptomatic OLTs.
Methods: Our database was queried over an 8-year period to identify patients undergoing repeat arthroscopy and microfracture as treatment for symptomatic OLTs. Phone surveys were conducted to assess residual pain, patient satisfaction, and need for subsequent surgery. We compared patient outcomes based on the size of their OLT (small lesions ≤150 mm2, large >150 mm2) and the presence or absence of subchondral cysts.
Results: We identified 14 patients who underwent repeat arthroscopy and microfracture for symptomatic OLTs. Patients reported reasonable satisfaction (7.6 ± 3.5 out of 10) but moderate residual pain (4.7 ± 3.4 out of 10) at midterm follow-up (5.1 ± 2.9 years). In total, 21% (3/14) of patients had undergone subsequent surgery. Patients with small (n = 5) and large OLTs (n = 9) had similar postoperative pain scores (4.2 ± 4.1 vs 4.9 ± 3.2) and postoperative satisfaction levels (6.4 ± 4.9 vs 8.3 ± 2.5).
Conclusion: At midterm follow-up, repeat arthroscopy for symptomatic OLTs demonstrated reasonable satisfaction but moderate residual pain. Lesion size or presence of subchondral cysts did not affect outcome, but our sample size was likely too small to detect statistically significant differences. These data show that repeat ankle arthroscopy can be performed safely with modest outcomes, and we hope that this report aids in managing patient expectations.Level of Evidence:Level IV Case Series.
背景关节镜治疗距骨(OLTs)症状性骨软骨病变的治疗方法存在争议。关于重复关节镜检查的作用,数据很少。在这里,我们描述了我们对有症状OLT的重复关节镜检查和微骨折的经验。方法对我们的数据库进行为期8年的查询,以确定接受重复关节镜检查和微骨折治疗有症状OLT的患者。进行电话调查以评估残余疼痛、患者满意度和后续手术的需求。我们根据OLT的大小(小病变≤150 mm2,大病变>150 mm2)和软骨下囊肿的存在与否对患者的预后进行了比较。结果我们确定了14名患者,他们因有症状的OLT而接受了重复关节镜检查和微骨折。患者在中期随访(5.1±2.9年)中报告了合理的满意度(7.6±3.5,满分10),但中度残余疼痛(4.7±3.4,满分10。总共有21%(3/14)的患者接受了后续手术。小型(n=5)和大型OLT(n=9)患者的术后疼痛评分相似(4.2±4.1 vs 4.9±3.2),术后满意度相似(6.4±4.9 vs 8.3±2.5)。病变大小或软骨下囊肿的存在不会影响结果,但我们的样本量可能太小,无法检测到统计学上的显著差异。这些数据表明,重复的踝关节镜检查可以安全地进行,结果适中,我们希望这份报告有助于管理患者的期望。证据级别:四级系列案件。