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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-02-2010 | Ankle

Treatment of osteochondral lesions of the talus: a systematic review

Authors: Maartje Zengerink, Peter A. A. Struijs, Johannes L. Tol, Cornelis Niek van Dijk

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2010

Abstract

The aim of this study was to summarize all eligible studies to compare the effectiveness of treatment strategies for osteochondral defects (OCD) of the talus. Electronic databases from January 1966 to December 2006 were systematically screened. The proportion of the patient population treated successfully was noted, and percentages were calculated. For each treatment strategy, study size weighted success rates were calculated. Fifty-two studies described the results of 65 treatment groups of treatment strategies for OCD of the talus. One randomized clinical trial was identified. Seven studies described the results of non-operative treatment, 4 of excision, 13 of excision and curettage, 18 of excision, curettage and bone marrow stimulation (BMS), 4 of an autogenous bone graft, 2 of transmalleolar drilling (TMD), 9 of osteochondral transplantation (OATS), 4 of autologous chondrocyte implantation (ACI), 3 of retrograde drilling and 1 of fixation. OATS, BMS and ACI scored success rates of 87, 85 and 76%, respectively. Retrograde drilling and fixation scored 88 and 89%, respectively. Together with the newer techniques OATS and ACI, BMS was identified as an effective treatment strategy for OCD of the talus. Because of the relatively high cost of ACI and the knee morbidity seen in OATS, we conclude that BMS is the treatment of choice for primary osteochondral talar lesions. However, due to great diversity in the articles and variability in treatment results, no definitive conclusions can be drawn. Further sufficiently powered, randomized clinical trials with uniform methodology and validated outcome measures should be initiated to compare the outcome of surgical strategies for OCD of the talus.

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Title: Treatment of osteochondral lesions of the talus: a systematic review
Authors: Maartje Zengerink
Peter A. A. Struijs
Johannes L. Tol
Cornelis Niek van Dijk
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2010
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-009-0942-6

At a glance: The STEP trials

Springer Medicine

Treatment of osteochondral lesions of the talus: a systematic review

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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