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| 1 | 早期负重对距骨骨软骨病损关节镜下修复术后关节功能恢复影响的前瞻性研究显示文摘目的探讨早期负重锻炼对距骨骨软骨病损 (osteochondral lesions of the talus,OLT) 经关节镜微骨折术后康复的影响。方法前瞻性纳入 80 例接受关节镜微骨折术治疗的 OLT 患者,根据随机数表将患者分为早期负重组 (40 例) 和延迟负重组 (40 例),其中早期负重组在术后第 1 天即开始部分负重锻炼、并于术后 4 周达到完全负重锻炼,而延迟负重组在术后第 5 周开始部分负重锻炼、于术后第 8 周达到完全负重锻炼。比较两组患者术后 1 年的 Berndt-Harty 分型、Mintz 分期情况,并比较两组患者术后 6 个月、12 个月和24 个月疼痛视觉模型评分 (visual analogue scale,VAS) 和 Tegner 活动指数差异。结果早期负重组和延迟负重组的术后 Berndt-Harty 分型和 Mintz 分期差异无统计学意义 (P>0.05)。两组术后 6 个月、12 个月和 24 个月的 AOFAS 评分分别为 (82.1±11.3) vs.(82.9±12.4)、(85.8±9.9) vs.(85.3±11.7)、(87.5±8.8) vs.(87.4±9.2),差异无统计学意义 (P>0.05);两组术后 6 个月、12 个月和 24 个月的 VAS 评分分别为 (2.6±0.4) vs.(2.4±0.8)、(2.4±0.5) vs.(2.4±0.4)、(1.5±0.5) vs.(1.5±0.3),差异无统计学意义 (P>0.05)。早期负重组患者术后 6 个月、12 个月和 24 个月的 Tegner 活动指数均显著高于延迟负重组,分别为 (4.5±1.0) vs.(2.6±0.8)、(4.7±1.2) vs.(3.7±0.9)、(4.7±1.0) vs.(3.9±1.1),差异有统计学意义 (P<0.05)。结论早期负重锻炼并不影响 OLT 患者术后踝关节的功能恢复,并且能够促进术后活动能力改善。 | 史长安 刘丽 王建伟 | 2020 | 中国骨与关节杂志2020，9，9： | 7 |
| 2 | Effects of Early Weightbearing on Microfracture Treatment of Osteochondral Lesions of Talus with Subchondral Bone Defects显示文摘When subchondral bone defects are present in osteochondral lesions of the talus(OCLT),it is inconclusive whether to allow early weightbearing after microfracture treatment because of the lack of effective support of the newly-formed fibrocartilage.After performing arthroscopic debridement and microfracture treatment on OCLT patients with subchondral bone defects,we allowed patients to have an early postoperative weightbearing exercise to observe their clinical outcome.Forty-two OCLT patients with subchondral bone defects were analyzed.Patients were randomly divided into two groups with 21 patients in each group.After arthroscopic debridement and microfracture treatment,group A was allowed to have early partial weightbearing while weightbearing was delayed in group B.Visual analogue scale(VAS)was used to evaluate joint pain before and after surgery.American Orthopaedic Foot and Ankle Society(AOFAS)anklc-hindfoot score was used to evaluate joint function.Tegner activity scale was used to assess patient's exercise level.The AOFAS ankle-hindfoot score in group A increased from 54.4 to 87.6,and that in group B increased from 54.9 to 87.3.The VAS score in group A decreased from 6.5 to 2.2,and that in group B decreased from 6.4 to 2.3.The Tegner activity scale increased from 2.6 to 4.4 in group A,and that in group B increased from 2.6 to 3.9.There was significant difference in the Tegner activity scale between group A and group B(P<0.05).It was suggested that when performing microfracture treatmenf on OCLT patients with subchondral bone defects,early postoperative weightbearing may achieve similar clinical outcomes as delayed weightbearing,and patients may be better able to return to sports. | Min WEI Yu WEI Yang LIU | 2019 | Current Medical Science2019，39，1： | 0 |
| 3 | Systematic review of bone marrow stimulation for osteochondral lesion of talus-evaluation for level and quality of clinical studies显示文摘AIM To clarify the quality of the studies indicating lesion size and/or containment as prognostic indicators of bone marrow stimulation(BMS) for osteochondral lesions of the talus(OLT). METHODS Two reviewers searched the Pub Med/MEDLINE and EMBASE databases using specific terms on March 2015 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. Predetermined variables were extracted for all the included studies. Level of evidence(LOE) was determined using previously published criteria by the Journal of Bone and Joint Surgery and methodological quality of evidence (MQOE) was evaluated using the Modified Coleman Methodology Score. RESULTS This review included 22 studies. Overall, 21 of the 22(95.5%) included studies were level Ⅳ or level Ⅲ evidences. The remaining study was a level Ⅱ evidence. MQOE analysis revealed 14 of the 22(63.6%) included studies having fair quality, 7(31.8%) studies having poor quality and only 1 study having excellent quality. CONCLUSION The evidence supporting the use of lesion size and containment as prognostic indicators of BMS for OLTs has been shown to be of low quality. | Youichi Yasui Laura Ramponi Dexter Seow Eoghan T Hurley Wataru Miyamoto Yoshiharu Shimozono John G Kennedy | 2017 | World Journal of Orthopedics2017，8，12： | 0 |
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