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Background <p>Osteochondral lesions of the talus (OLTs) involve damage to the articular cartilage and underlying bone, posing a therapeutic challenge due to the limited intrinsic healing capacity of cartilage. This review aims to provide mid- to long-term follow-ups for joint preservation procedures for OLTs through analysis of patient-reported outcomes (PROs), rates of return to activity/sport/work, and survival rates/complications.</p> Methods <p>The guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed to perform this systematic review in PubMed, Embase, and Cochrane Library for studies evaluating surgical treatment for OLTs at a minimum 5-year follow-up. Quality and risk of bias assessment were completed using the Methodological Index for Non-Randomized Studies criteria.</p> Results <p>43 studies with a total of 2721 patients with an age range of 23.9 to 47.7&#xa0;years, defect size of 0.9 to 29.1 cm<sup>2</sup>, and follow-up of 5 to 24.1&#xa0;years were included. Survival rates, defined as no revision surgeries, at the latest follow-up, for bone marrow stimulation (8 studies), autologous chondrocyte implantation (6 studies), matrix-associated chondrocyte implantation (3 studies), autologous matrix-induced chondrogenesis (AMIC) (2 studies), OATS (7 studies), and bone marrow aspirate concentrate were 87.4 to 100%, 75 to 100%, 55.6 to 100%, 84.2 to 92.1%, 56.4 to 100%, and 90.1 to 95.3%. respectively. Survival rates for the other techniques, reported in separate studies, were biphasic bioresorbable scaffold (100%), matrix-induced stem cell transplantation (100%), AMIC plus peripheral blood concentrate (96.9%), microfracture plus platelet-rich plasma and hyaluronic acid (91.23%), autologous tibia osteoperiosteal graft (86.67%), arthroscopic lift-drill-fill-fix (66.7%), and particulates juvenile allograft cartilage implantation (53.5%). The majority of studies demonstrated significant PRO improvements (p &lt; 0.05) at the latest follow-up.</p> Conclusion <p>BMS remained the most commonly used technique (primarily used for smaller lesions) and produced survival rates comparable to other techniques included in this study. Most patients across all the techniques analyzed in this study had significant PRO improvements at the latest follow-up.</p>

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Mid- to long-term outcomes of osteochondral lesions of the talus repair: a systematic review

  • 期刊论文

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  • 发表日期：

    2025年10月14日

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  • Jimmy Wen,
  • Burhaan Syed,
  • Ihab Abed,
  • Mouhamad Shehabat,
  • Muzammil Akhtar,
  • Daniel Razick,
  • Arsh Alam,
  • Christopher Kreuelen

摘要

Background

Osteochondral lesions of the talus (OLTs) involve damage to the articular cartilage and underlying bone, posing a therapeutic challenge due to the limited intrinsic healing capacity of cartilage. This review aims to provide mid- to long-term follow-ups for joint preservation procedures for OLTs through analysis of patient-reported outcomes (PROs), rates of return to activity/sport/work, and survival rates/complications.

Methods

The guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed to perform this systematic review in PubMed, Embase, and Cochrane Library for studies evaluating surgical treatment for OLTs at a minimum 5-year follow-up. Quality and risk of bias assessment were completed using the Methodological Index for Non-Randomized Studies criteria.

Results

43 studies with a total of 2721 patients with an age range of 23.9 to 47.7 years, defect size of 0.9 to 29.1 cm2, and follow-up of 5 to 24.1 years were included. Survival rates, defined as no revision surgeries, at the latest follow-up, for bone marrow stimulation (8 studies), autologous chondrocyte implantation (6 studies), matrix-associated chondrocyte implantation (3 studies), autologous matrix-induced chondrogenesis (AMIC) (2 studies), OATS (7 studies), and bone marrow aspirate concentrate were 87.4 to 100%, 75 to 100%, 55.6 to 100%, 84.2 to 92.1%, 56.4 to 100%, and 90.1 to 95.3%. respectively. Survival rates for the other techniques, reported in separate studies, were biphasic bioresorbable scaffold (100%), matrix-induced stem cell transplantation (100%), AMIC plus peripheral blood concentrate (96.9%), microfracture plus platelet-rich plasma and hyaluronic acid (91.23%), autologous tibia osteoperiosteal graft (86.67%), arthroscopic lift-drill-fill-fix (66.7%), and particulates juvenile allograft cartilage implantation (53.5%). The majority of studies demonstrated significant PRO improvements (p < 0.05) at the latest follow-up.

Conclusion

BMS remained the most commonly used technique (primarily used for smaller lesions) and produced survival rates comparable to other techniques included in this study. Most patients across all the techniques analyzed in this study had significant PRO improvements at the latest follow-up.