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Evidence-based Treatment of Failed Primary Osteochondral Lesions of the Talus: A Systematic Review on Clinical Outcomes of Bone Marrow Stimulation.
Dahmen, Jari; Hurley, Eoghan T; Shimozono, Yoshiharu; Murawski, Christopher D; Stufkens, Sjoerd A S; Kerkhoffs, Gino M M J; Kennedy, John G.
Afiliación
  • Dahmen J; Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
  • Hurley ET; Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, the Netherlands.
  • Shimozono Y; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center Amsterdam UMC, Amsterdam, the Netherlands.
  • Murawski CD; Department of Orthopaedic Surgery, NYU Langone Health, New York, NY, USA.
  • Stufkens SAS; Department of Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.
  • Kerkhoffs GMMJ; Department of Orthopaedic Surgery, NYU Langone Health, New York, NY, USA.
  • Kennedy JG; Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Cartilage ; 13(1_suppl): 1411S-1421S, 2021 12.
Article en En | MEDLINE | ID: mdl-33618537
OBJECTIVE: The purpose of this study is to systematically review the literature and to evaluate the outcomes following bone marrow stimulation (BMS) for nonprimary osteochondral lesions of the talus (OLT). DESIGN: A literature search was performed to identify studies published using PubMed (MEDLINE), EMBASE, CDSR, DARE, and CENTRAL. The review was performed according to the PRISMA guidelines. Two authors separately and independently screened the search results and conducted the quality assessment using the Methodological Index for Non-Randomized Studies (MINORS). Studies were pooled on clinical, sports, work, and imaging outcomes, as well as revision rates and complications. The primary outcome was clinical success rate. RESULTS: Five studies with 70 patients were included in whom nonprimary OLTs were treated with secondary BMS. The pooled clinical success rate was 61% (95% confidence interval [CI], 50-72). The rate of return to any level of sport was 83% (95% CI, 70-91), while the return to pre-injury level of sport was 55% (95% CI, 34-74). The rate of return to work was 92% (95% CI, 78-97), and the complication rate was assessed to be 10% (95% CI, 4-22). Imaging outcomes were heterogeneous in outcome assessment, though a depressed subchondral bone plate was observed in 91% of the patients. The revision rate was 27% (95% CI, 18-40). CONCLUSIONS: The overall success rate of arthroscopic BMS for nonprimary osteochondral lesions of the talus was 61%, including a revision rate of 27%. Return to sports, work, and complication outcomes yielded fair to good results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroscopía / Enfermedades Óseas / Médula Ósea / Astrágalo / Cartílago Tipo de estudio: Clinical_trials / Guideline / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Cartilage Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroscopía / Enfermedades Óseas / Médula Ósea / Astrágalo / Cartílago Tipo de estudio: Clinical_trials / Guideline / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Cartilage Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos