Higher preoperative range of motion is predictive of good mid-term results in the surgical management of osteochondral lesions of the talus: a prospective multicentric study
Introduction Osteochondral lesions of the talus (OLT) are a frequent cause of pain in young patients and a new CT arthrographic classification system of OLT was recently proposed to help guide the choices of and standardize the indications for surgical treatment. The primary hypothesis was that this...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2023-08, Vol.31 (8), p.3044-3050 |
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| creator | Amouyel, T. Barbier, O. De L’Escalopier, N. Cordier, G. Baudrier, N. Benoist, J. Ferrière, V. Dubois Wackenheim, F. Leiber Mainard, D. Padiolleau, G. Lopes, R. |
| description | Introduction
Osteochondral lesions of the talus (OLT) are a frequent cause of pain in young patients and a new CT arthrographic classification system of OLT was recently proposed to help guide the choices of and standardize the indications for surgical treatment. The primary hypothesis was that this algorithm would result in a postoperative AOFAS score of ≥ 80/100. The secondary hypothesis was to identify the preoperative factors of successful surgery.
Methods
This was a prospective observational multicenter study. Eighty-six patients who underwent surgery for OLT after at least 6 months of unsuccessful conservative management were included for a mean follow-up of 15 months (12–36). Forty-nine patients with stage 1 OLT underwent microperforation, 2 patients with stage 2 OLT underwent a lift, drill, fill, and fix graft procedure with screw fixation, and 35 patients with stage 3 OLT were treated with mosaicplasty.
Results
After a follow-up of at least 1 year, 56 patients (65%) had an AOFAS score > 80 and the mean AOFAS score was 82 (16–100). A lower BMI (
p
= 0.038), a higher preoperative range of motion in the ankle (
p
= 0.033), higher preoperative AOFAS and FAOS scores (
p
= 0.001 and
p
= 0.011), and the presence of a preoperative bone bruise on MRI (
p
= 0.020) were good prognostic factors on univariate analysis. The presence of grade 1 osteoarthritis on the Van Dijk classification was predictive of a poor prognosis (
p
= 0.044). Multivariate analysis showed that a good preoperative range of motion (OR = 1.080 [1.020–1.150]
p
= 0.01) was predictive of a positive outcome, while grade 1 osteoarthritis was predictive of a poor outcome (OR = 0.147 [0.036–0.603]
p
= 0.008). The postoperative AOFAS decreased in six patients and 17 patients had at least one complication: six dysthesias of the superficial fibular nerve, two of the sural nerve, and nine stage 1 complex regional pain syndromes.
Conclusion
The new algorithm for OLT resulted in a postoperative AOFAS score of ≥ 80/100 in 65% of cases. The positive predictive factors of a successful postoperative outcome were the presence of a good preoperative range of motion and the absence of preoperative osteoarthritis.
Level of evidence
Level II. |
| doi_str_mv | 10.1007/s00167-022-06876-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2624200007</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2624200007</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-24f9c5ab0fc53134a11ec878513f329d2c62db708f126847ca6f6091fe05a62c3</originalsourceid><addsrcrecordid>eNp9Uc1u1DAQthCILoUX4IAsceES8E9iJ9xQVShSJS5wtrzOZNdVEi8eh6oPxTsyaQpIHDjZ8vc344-xl1K8lULYdyiENLYSSlXCtNZUt4_YTtZaV1bX9jHbia5WlRKNOWPPEG-EoGvdPWVnuiFIdHbHfl7FwxEyP2VIJ8i-xB_As58PwNPAp1RimnnEFe9juEfp_ZBSz6fYVwXyxDPgMhbkceblCByXfIjBj3zysz_ABHNZNQkLpHBMc58JGwHJGVdg1RQ_Lviee8pJeIItaCLXGEieY-BYlv7uOXsy-BHhxcN5zr59vPx6cVVdf_n0-eLDdRW0bUql6qELjd-LITRa6tpLCaG1bSP1oFXXq2BUv7eiHaQybW2DN4MRnRxANN6ooM_Zm82Xxvm-ABY3RQwwjn6GtKBTRtWKvlNYor7-h3qTljzTdE61umtaLRtBLLWxAu2HGQZ3ynHy-c5J4dYy3VamozLdfZnulkSvHqyX_QT9H8nv9oigNwISRJXlv9n_sf0FOl6uQQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2839583150</pqid></control><display><type>article</type><title>Higher preoperative range of motion is predictive of good mid-term results in the surgical management of osteochondral lesions of the talus: a prospective multicentric study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Amouyel, T. ; Barbier, O. ; De L’Escalopier, N. ; Cordier, G. ; Baudrier, N. ; Benoist, J. ; Ferrière, V. Dubois ; Wackenheim, F. Leiber ; Mainard, D. ; Padiolleau, G. ; Lopes, R.</creator><creatorcontrib>Amouyel, T. ; Barbier, O. ; De L’Escalopier, N. ; Cordier, G. ; Baudrier, N. ; Benoist, J. ; Ferrière, V. Dubois ; Wackenheim, F. Leiber ; Mainard, D. ; Padiolleau, G. ; Lopes, R. ; French Arthroscopic Society</creatorcontrib><description>Introduction
Osteochondral lesions of the talus (OLT) are a frequent cause of pain in young patients and a new CT arthrographic classification system of OLT was recently proposed to help guide the choices of and standardize the indications for surgical treatment. The primary hypothesis was that this algorithm would result in a postoperative AOFAS score of ≥ 80/100. The secondary hypothesis was to identify the preoperative factors of successful surgery.
Methods
This was a prospective observational multicenter study. Eighty-six patients who underwent surgery for OLT after at least 6 months of unsuccessful conservative management were included for a mean follow-up of 15 months (12–36). Forty-nine patients with stage 1 OLT underwent microperforation, 2 patients with stage 2 OLT underwent a lift, drill, fill, and fix graft procedure with screw fixation, and 35 patients with stage 3 OLT were treated with mosaicplasty.
Results
After a follow-up of at least 1 year, 56 patients (65%) had an AOFAS score > 80 and the mean AOFAS score was 82 (16–100). A lower BMI (
p
= 0.038), a higher preoperative range of motion in the ankle (
p
= 0.033), higher preoperative AOFAS and FAOS scores (
p
= 0.001 and
p
= 0.011), and the presence of a preoperative bone bruise on MRI (
p
= 0.020) were good prognostic factors on univariate analysis. The presence of grade 1 osteoarthritis on the Van Dijk classification was predictive of a poor prognosis (
p
= 0.044). Multivariate analysis showed that a good preoperative range of motion (OR = 1.080 [1.020–1.150]
p
= 0.01) was predictive of a positive outcome, while grade 1 osteoarthritis was predictive of a poor outcome (OR = 0.147 [0.036–0.603]
p
= 0.008). The postoperative AOFAS decreased in six patients and 17 patients had at least one complication: six dysthesias of the superficial fibular nerve, two of the sural nerve, and nine stage 1 complex regional pain syndromes.
Conclusion
The new algorithm for OLT resulted in a postoperative AOFAS score of ≥ 80/100 in 65% of cases. The positive predictive factors of a successful postoperative outcome were the presence of a good preoperative range of motion and the absence of preoperative osteoarthritis.
Level of evidence
Level II.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-022-06876-w</identifier><identifier>PMID: 35094097</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Algorithms ; Ankle ; Arthritis ; Bone implants ; Cartilage, Articular - surgery ; Classification ; Humans ; Hypotheses ; Knee ; Lesions ; Medical prognosis ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Nerves ; Orthopedics ; Osteoarthritis ; Osteoarthritis - pathology ; Pain ; Patients ; Prospective Studies ; Range of motion ; Range of Motion, Articular ; Retrospective Studies ; Sports Medicine ; Sural nerve ; Surgery ; Surgical outcomes ; Talus ; Talus - surgery ; Treatment Outcome</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023-08, Vol.31 (8), p.3044-3050</ispartof><rights>The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2022</rights><rights>2022. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).</rights><rights>The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-24f9c5ab0fc53134a11ec878513f329d2c62db708f126847ca6f6091fe05a62c3</citedby><cites>FETCH-LOGICAL-c375t-24f9c5ab0fc53134a11ec878513f329d2c62db708f126847ca6f6091fe05a62c3</cites><orcidid>0000-0002-4666-3518</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-022-06876-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-022-06876-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35094097$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amouyel, T.</creatorcontrib><creatorcontrib>Barbier, O.</creatorcontrib><creatorcontrib>De L’Escalopier, N.</creatorcontrib><creatorcontrib>Cordier, G.</creatorcontrib><creatorcontrib>Baudrier, N.</creatorcontrib><creatorcontrib>Benoist, J.</creatorcontrib><creatorcontrib>Ferrière, V. Dubois</creatorcontrib><creatorcontrib>Wackenheim, F. Leiber</creatorcontrib><creatorcontrib>Mainard, D.</creatorcontrib><creatorcontrib>Padiolleau, G.</creatorcontrib><creatorcontrib>Lopes, R.</creatorcontrib><creatorcontrib>French Arthroscopic Society</creatorcontrib><title>Higher preoperative range of motion is predictive of good mid-term results in the surgical management of osteochondral lesions of the talus: a prospective multicentric study</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Introduction
Osteochondral lesions of the talus (OLT) are a frequent cause of pain in young patients and a new CT arthrographic classification system of OLT was recently proposed to help guide the choices of and standardize the indications for surgical treatment. The primary hypothesis was that this algorithm would result in a postoperative AOFAS score of ≥ 80/100. The secondary hypothesis was to identify the preoperative factors of successful surgery.
Methods
This was a prospective observational multicenter study. Eighty-six patients who underwent surgery for OLT after at least 6 months of unsuccessful conservative management were included for a mean follow-up of 15 months (12–36). Forty-nine patients with stage 1 OLT underwent microperforation, 2 patients with stage 2 OLT underwent a lift, drill, fill, and fix graft procedure with screw fixation, and 35 patients with stage 3 OLT were treated with mosaicplasty.
Results
After a follow-up of at least 1 year, 56 patients (65%) had an AOFAS score > 80 and the mean AOFAS score was 82 (16–100). A lower BMI (
p
= 0.038), a higher preoperative range of motion in the ankle (
p
= 0.033), higher preoperative AOFAS and FAOS scores (
p
= 0.001 and
p
= 0.011), and the presence of a preoperative bone bruise on MRI (
p
= 0.020) were good prognostic factors on univariate analysis. The presence of grade 1 osteoarthritis on the Van Dijk classification was predictive of a poor prognosis (
p
= 0.044). Multivariate analysis showed that a good preoperative range of motion (OR = 1.080 [1.020–1.150]
p
= 0.01) was predictive of a positive outcome, while grade 1 osteoarthritis was predictive of a poor outcome (OR = 0.147 [0.036–0.603]
p
= 0.008). The postoperative AOFAS decreased in six patients and 17 patients had at least one complication: six dysthesias of the superficial fibular nerve, two of the sural nerve, and nine stage 1 complex regional pain syndromes.
Conclusion
The new algorithm for OLT resulted in a postoperative AOFAS score of ≥ 80/100 in 65% of cases. The positive predictive factors of a successful postoperative outcome were the presence of a good preoperative range of motion and the absence of preoperative osteoarthritis.
Level of evidence
Level II.</description><subject>Algorithms</subject><subject>Ankle</subject><subject>Arthritis</subject><subject>Bone implants</subject><subject>Cartilage, Articular - surgery</subject><subject>Classification</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Knee</subject><subject>Lesions</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Nerves</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis - pathology</subject><subject>Pain</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Range of motion</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>Sports Medicine</subject><subject>Sural nerve</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Talus</subject><subject>Talus - surgery</subject><subject>Treatment Outcome</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9Uc1u1DAQthCILoUX4IAsceES8E9iJ9xQVShSJS5wtrzOZNdVEi8eh6oPxTsyaQpIHDjZ8vc344-xl1K8lULYdyiENLYSSlXCtNZUt4_YTtZaV1bX9jHbia5WlRKNOWPPEG-EoGvdPWVnuiFIdHbHfl7FwxEyP2VIJ8i-xB_As58PwNPAp1RimnnEFe9juEfp_ZBSz6fYVwXyxDPgMhbkceblCByXfIjBj3zysz_ABHNZNQkLpHBMc58JGwHJGVdg1RQ_Lviee8pJeIItaCLXGEieY-BYlv7uOXsy-BHhxcN5zr59vPx6cVVdf_n0-eLDdRW0bUql6qELjd-LITRa6tpLCaG1bSP1oFXXq2BUv7eiHaQybW2DN4MRnRxANN6ooM_Zm82Xxvm-ABY3RQwwjn6GtKBTRtWKvlNYor7-h3qTljzTdE61umtaLRtBLLWxAu2HGQZ3ynHy-c5J4dYy3VamozLdfZnulkSvHqyX_QT9H8nv9oigNwISRJXlv9n_sf0FOl6uQQ</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Amouyel, T.</creator><creator>Barbier, O.</creator><creator>De L’Escalopier, N.</creator><creator>Cordier, G.</creator><creator>Baudrier, N.</creator><creator>Benoist, J.</creator><creator>Ferrière, V. Dubois</creator><creator>Wackenheim, F. Leiber</creator><creator>Mainard, D.</creator><creator>Padiolleau, G.</creator><creator>Lopes, R.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4666-3518</orcidid></search><sort><creationdate>20230801</creationdate><title>Higher preoperative range of motion is predictive of good mid-term results in the surgical management of osteochondral lesions of the talus: a prospective multicentric study</title><author>Amouyel, T. ; Barbier, O. ; De L’Escalopier, N. ; Cordier, G. ; Baudrier, N. ; Benoist, J. ; Ferrière, V. Dubois ; Wackenheim, F. Leiber ; Mainard, D. ; Padiolleau, G. ; Lopes, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-24f9c5ab0fc53134a11ec878513f329d2c62db708f126847ca6f6091fe05a62c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Algorithms</topic><topic>Ankle</topic><topic>Arthritis</topic><topic>Bone implants</topic><topic>Cartilage, Articular - surgery</topic><topic>Classification</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Knee</topic><topic>Lesions</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Nerves</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis - pathology</topic><topic>Pain</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Range of motion</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>Sports Medicine</topic><topic>Sural nerve</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Talus</topic><topic>Talus - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amouyel, T.</creatorcontrib><creatorcontrib>Barbier, O.</creatorcontrib><creatorcontrib>De L’Escalopier, N.</creatorcontrib><creatorcontrib>Cordier, G.</creatorcontrib><creatorcontrib>Baudrier, N.</creatorcontrib><creatorcontrib>Benoist, J.</creatorcontrib><creatorcontrib>Ferrière, V. Dubois</creatorcontrib><creatorcontrib>Wackenheim, F. Leiber</creatorcontrib><creatorcontrib>Mainard, D.</creatorcontrib><creatorcontrib>Padiolleau, G.</creatorcontrib><creatorcontrib>Lopes, R.</creatorcontrib><creatorcontrib>French Arthroscopic Society</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amouyel, T.</au><au>Barbier, O.</au><au>De L’Escalopier, N.</au><au>Cordier, G.</au><au>Baudrier, N.</au><au>Benoist, J.</au><au>Ferrière, V. Dubois</au><au>Wackenheim, F. Leiber</au><au>Mainard, D.</au><au>Padiolleau, G.</au><au>Lopes, R.</au><aucorp>French Arthroscopic Society</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher preoperative range of motion is predictive of good mid-term results in the surgical management of osteochondral lesions of the talus: a prospective multicentric study</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>31</volume><issue>8</issue><spage>3044</spage><epage>3050</epage><pages>3044-3050</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Introduction
Osteochondral lesions of the talus (OLT) are a frequent cause of pain in young patients and a new CT arthrographic classification system of OLT was recently proposed to help guide the choices of and standardize the indications for surgical treatment. The primary hypothesis was that this algorithm would result in a postoperative AOFAS score of ≥ 80/100. The secondary hypothesis was to identify the preoperative factors of successful surgery.
Methods
This was a prospective observational multicenter study. Eighty-six patients who underwent surgery for OLT after at least 6 months of unsuccessful conservative management were included for a mean follow-up of 15 months (12–36). Forty-nine patients with stage 1 OLT underwent microperforation, 2 patients with stage 2 OLT underwent a lift, drill, fill, and fix graft procedure with screw fixation, and 35 patients with stage 3 OLT were treated with mosaicplasty.
Results
After a follow-up of at least 1 year, 56 patients (65%) had an AOFAS score > 80 and the mean AOFAS score was 82 (16–100). A lower BMI (
p
= 0.038), a higher preoperative range of motion in the ankle (
p
= 0.033), higher preoperative AOFAS and FAOS scores (
p
= 0.001 and
p
= 0.011), and the presence of a preoperative bone bruise on MRI (
p
= 0.020) were good prognostic factors on univariate analysis. The presence of grade 1 osteoarthritis on the Van Dijk classification was predictive of a poor prognosis (
p
= 0.044). Multivariate analysis showed that a good preoperative range of motion (OR = 1.080 [1.020–1.150]
p
= 0.01) was predictive of a positive outcome, while grade 1 osteoarthritis was predictive of a poor outcome (OR = 0.147 [0.036–0.603]
p
= 0.008). The postoperative AOFAS decreased in six patients and 17 patients had at least one complication: six dysthesias of the superficial fibular nerve, two of the sural nerve, and nine stage 1 complex regional pain syndromes.
Conclusion
The new algorithm for OLT resulted in a postoperative AOFAS score of ≥ 80/100 in 65% of cases. The positive predictive factors of a successful postoperative outcome were the presence of a good preoperative range of motion and the absence of preoperative osteoarthritis.
Level of evidence
Level II.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35094097</pmid><doi>10.1007/s00167-022-06876-w</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-4666-3518</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023-08, Vol.31 (8), p.3044-3050 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2624200007 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals - AutoHoldings |
| subjects | Algorithms Ankle Arthritis Bone implants Cartilage, Articular - surgery Classification Humans Hypotheses Knee Lesions Medical prognosis Medicine Medicine & Public Health Multivariate analysis Nerves Orthopedics Osteoarthritis Osteoarthritis - pathology Pain Patients Prospective Studies Range of motion Range of Motion, Articular Retrospective Studies Sports Medicine Sural nerve Surgery Surgical outcomes Talus Talus - surgery Treatment Outcome |
| title | Higher preoperative range of motion is predictive of good mid-term results in the surgical management of osteochondral lesions of the talus: a prospective multicentric study |
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