Current Medical Science
DOI doi/10.100刀si1596-019-2004-8
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Effects of Early Weightbearing on Microfracture Treatment of Osteochondral Lesions of Talus with Subchondral Bone Defects
Min WEI
*,Yu WEI,Yang LIU
Sports Medicine Center,Department of Orthopedics Surgery,Chine PLA General Hospital,Beijing100853,China
©Huazhong University of Science and Technology2019
Summary:When subchondral bone defects are prent in osteochondral lesions of the talus(OCLT),
it is inconclusive whether to allow early weightbearing after microfracture treatment becau of
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元宵节的图画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 exerci to obrve their clinical
outcome.Forty-two OCLT patients with subchondral bone defects were analyzed.Patients were
randomly divided into two groups with21patients 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 ud to evaluate joint pain
before and after surgery.American Orthopaedic Foot and Ankle Society(AOFAS)anklc-hindfoot
score was ud to evaluate joint function.Tegner activity scale was ud to asss patient's exerci
学校宣传片解说词level.The AOFAS ankle-hindfoot score in group A incread from54.4to87.6,and that in group B
incread from54.9to87.3.The VAS score in group A decread from6.5to2.2,and that in group
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B decread from6.4to2.3.The Tegner activity scale incread from2.6to4.4in group A,and
that in group B incread from2.6to3.9.There was significant difference in the Tegner activity
秋天的菠菜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.
武昌江滩Key words:osteochondral lesions of the talus;subchondral bone;arthroscopic microfracture;
weightbearing time
Osteochondral lesions of the talus(OCLT)are injuries involving the articular cartilage of the talus and its subchondral bone[1]and are common in ankle sprain. When the talus is twisted at the ankle,the articular cartilage on the surface of the talus may be subjected to vertical compression or horizontal shear,resulting in bruising,softening and fissures,and subchondral bone below it may also be damag
ed.Due to the poor healing ability of articular cartilage,satisfactory outcomes were difficult to achieve with conrvative treatment⑺.
There are a variety of surgical methods that can be ud to treat OCLT,including drilli n g,micro f racture and osteochondral transplantation131.Among them, arthroscopic microfracture is the preferred method to treat OCLT becau of its ea and reliability141.The basic principle of micro f racture is to pen e trate the subchondral bone to induce the repair reaction,forming "Corresponding author,E-mail: fibrocartilage covering the wound.The location and size of articular cartilage damage,subchondral bone defects and postoperative exerci will all affect the efficacy of microfracture treatment⑸.After the initial formation of fibrocartilage,it needs to be stabilized to reach certain mechanical strength.Thus,it is generally believed that after microfracture treatment weightbearing should be delayed161.However,more and more recent studies have shown that early weightbearing does not have a negative effect on the efficacy of microfracture treatment1"71.For OCLT with subchondral bone defects, it is still in c onclusive whether after microfracture treatme n t newly formed fibrocartilages without effective bone support can tolerate early weighbearing.
We treated OCLT patients with subchondral bone defects with arthroscopic debridement and microfr
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acture,allowing patients to have early post・operative weightbearing exercis to obrve their clinical outcomes.
