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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

28.09.2021 | Orthopaedic Surgery

Descriptive analysis and short-term follow-up clinical results of osteochondral lesions of the distal tibia based on data of the German Cartilage Register (Knorpelregister^® DGOU)

verfasst von: Oliver Gottschalk, Daniel Körner, Matthias Aurich, Christian Plaass, Daniel Günther, Hubert Hörterer, Jan Bruder, Markus Walther

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 2/2023

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Abstract

Introduction

An increasing number of ankle injuries with osteochondral lesions (OCL) also include lesions of the distal tibia. Therefore, the German Cartilage Society database is used to describe and examine the characteristics of these lesions and, early on, the results of different surgical therapies on the clinical outcome.

Materials and methods

Forty-seven patients out of 844 registered in the German Cartilage Society database met the inclusion criteria showing an OCL of the distal tibia (OLDT). Sixteen of them also presented a 1-year follow-up regarding the Foot and Ankle Ability Measure (FAAM). Further evaluations were included in the follow-up, such as the Foot and Ankle Outcome Score (FAOS) and the Visual Analogue Scale for pain (VAS).

Results

The patients’ mean age was 35 ± 11 with a mean BMI in the range of overweight (26/27 ± 5 kg/m²). The lesions were equally distributed on the articular surface of the distal tibia. Most patients were operated using anterior ankle arthroscopy [n_T 34 (72%); n_S 13 (81%)], while some (n_T 9; n_S 4) converted to open procedures. Almost 90% staged III and IV in the ICRS classification. Debridement, bone marrow stimulation, solid scaffolds, and liquid filler were the treatment choices among the subgroup. All therapies led to a clinical improvement between pre-op and 1-year follow-up but not to a significant level.

Conclusion

This study presents baseline data of OLDT based on data from a large database. BMS and scaffolds were the treatment of choice but did not present significant improvement after a 1-year follow-up.

Akoh CC, Dibbern K, Amendola A, Sittapairoj T, Anderson DD, Phisitkul P (2017) Effect of ankle position and noninvasive distraction on arthroscopic accessibility of the distal tibial plafond. Foot Ankle Int 38(10):1152–1159CrossRefPubMed

Athanasiou KA, Niederauer GG, Schenck RC Jr (1995) Biomechanical topography of human ankle cartilage. Ann Biomed Eng 23(5):697–704CrossRefPubMed

Aurich M, Albrecht D, Angele P et al (2017) Treatment of osteochondral lesions in the ankle: a guideline from the Group “Clinical Tissue Regeneration” of the German Society of Orthopaedics and Traumatology (DGOU). Zeitschrift fur Orthopadie und Unfallchirurgie 155(1):92–99PubMed

Baldassarri M, Perazzo L, Ricciarelli M, Natali S, Vannini F, Buda R (2018) Regenerative treatment of osteochondral lesions of distal tibial plafond. Eur J Orthop Surg Traumatol 28(6):1199–1207CrossRefPubMed

Berndt AL, Harty M (1959) Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am 41-A:988–1020CrossRefPubMed

Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC (2012) Arthroscopic treatment of osteochondral lesions of the tibial plafond. Foot Ankle Int 33(8):662–668CrossRefPubMed

Dombrowski ME, Yasui Y, Murawski CD et al (2018) Conservative management and biological treatment strategies: proceedings of the international consensus meeting on cartilage repair of the ankle. Foot Ankle Int 39(1):9s–15sCrossRefPubMed

Ferkel RD, Chams RN (2007) Chronic lateral instability: arthroscopic findings and long-term results. Foot Ankle Int 28(1):24–31CrossRefPubMed

Flick AB, Gould N (1985) Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. Foot Ankle 5(4):165–185CrossRefPubMed

10.

Gottschalk O, Altenberger S, Baumbach S et al (2017) Functional medium-term results after autologous matrix-induced chondrogenesis for osteochondral lesions of the talus: a 5-year prospective cohort study. J Foot Ankle Surg. https://doi.org/10.1053/j.jfas.2017.05.002CrossRefPubMed

11.

Irwin RM, Shimozono Y, Yasui Y, Megill R, Deyer TW, Kennedy JG (2018) Incidence of coexisting talar and tibial osteochondral lesions correlates with patient age and lesion location. Orthop J Sports Med 6(8):2325967118790965CrossRefPubMedPubMedCentral

12.

Lambers KTA, Dahmen J, Altink JN, Reilingh ML, van Bergen CJA, Kerkhoffs G (2020) Bone marrow stimulation for talar osteochondral lesions at long-term follow-up shows a high sports participation though a decrease in clinical outcomes over time. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06250-8CrossRefPubMedPubMedCentral

13.

Loomer R, Fisher C, Lloyd-Smith R, Sisler J, Cooney T (1993) Osteochondral lesions of the talus. Am J Sports Med 21(1):13–19CrossRefPubMed

14.

Martin RL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM (2005) Evidence of validity for the foot and ankle ability measure (FAAM). Foot Ankle Int 26(11):968–983CrossRefPubMed

15.

Maurer J, Grotejohann B, Jenkner C et al (2016) A registry for evaluation of efficiency and safety of surgical treatment of cartilage defects: the German Cartilage Registry (KnorpelRegister DGOU). JMIR Res Protoc 5(2):e122CrossRefPubMedPubMedCentral

16.

Miska M, Wiewiorski M, Valderrabano V (2012) Reconstruction of a large osteochondral lesion of the distal tibia with an iliac crest graft and autologous matrix-induced chondrogenesis (AMIC): a case report. J Foot Ankle Surg 51(5):680–683CrossRefPubMed

17.

Mologne TS, Ferkel RD (2007) Arthroscopic treatment of osteochondral lesions of the distal tibia. Foot Ankle Int 28(8):865–872CrossRefPubMed

18.

Nauck T, Lohrer H (2011) Translation, cross-cultural adaption and validation of the German version of the Foot and Ankle Ability Measure for patients with chronic ankle instability. Br J Sports Med 45(10):785–790CrossRefPubMed

19.

Regier M, Petersen JP, Hamurcu A et al (2016) High incidence of osteochondral lesions after open reduction and internal fixation of displaced ankle fractures: Medium-term follow-up of 100 cases. Injury 47(3):757–761CrossRefPubMed

20.

Ross KA, Hannon CP, Deyer TW et al (2014) Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond. J Bone Joint Surg Am 96(20):1708–1715CrossRefPubMed

21.

Sharma UK, Dhungel K, Pokhrel D, Tamang S, Parajuli NP (2018) Magnetic resonance imaging evaluation of musculoskeletal diseases of ankle and foot. Kathmandu Univ Med J (KUMJ) 16(61):28–34PubMed

22.

van Bergen CJ, Sierevelt IN, Hoogervorst P, Waizy H, van Dijk CN, Becher C (2014) Translation and validation of the German version of the foot and ankle outcome score. Arch Orthop Trauma Surg 134(7):897–901CrossRefPubMed

23.

van den Borne MP, Raijmakers NJ, Vanlauwe J et al (2007) International Cartilage Repair Society (ICRS) and Oswestry macroscopic cartilage evaluation scores validated for use in Autologous Chondrocyte Implantation (ACI) and microfracture. Osteoarthritis Cartilage 15(12):1397–1402CrossRefPubMed

24.

Walther M, Valderrabano V, Wiewiorski M et al (2020) Is there clinical evidence to support autologous matrix-induced chondrogenesis (AMIC) for chondral defects in the talus? A systematic review and meta-analysis. Foot Ankle Surg. https://doi.org/10.1016/j.fas.2020.07.011CrossRefPubMed

25.

You JY, Lee GY, Lee JW, Lee E, Kang HS (2016) An osteochondral lesion of the distal tibia and fibula in patients with an osteochondral lesion of the talus on MRI: prevalence, location, and concomitant ligament and tendon injuries. AJR Am J Roentgenol 206(2):366–372CrossRefPubMed

Titel: Descriptive analysis and short-term follow-up clinical results of osteochondral lesions of the distal tibia based on data of the German Cartilage Register (Knorpelregister® DGOU)
verfasst von: Oliver Gottschalk
Daniel Körner
Matthias Aurich
Christian Plaass
Daniel Günther
Hubert Hörterer
Jan Bruder
Markus Walther
Publikationsdatum: 28.09.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 2/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04167-6

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Descriptive analysis and short-term follow-up clinical results of osteochondral lesions of the distal tibia based on data of the German Cartilage Register (Knorpelregister^® DGOU)