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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2019

01-09-2019 | Ankle

High reported rate of return to play following bone marrow stimulation for osteochondral lesions of the talus

Authors: Eoghan T. Hurley, Yoshiharu Shimozono, Niall P. McGoldrick, Charles L. Myerson, Youichi Yasui, John G. Kennedy

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2019

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Abstract

Purpose

The purpose of this study is to systematically review the literature and to evaluate the reported rehabilitation protocols, return to play guidelines and subsequent rates and timing of return to play following bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLT).

Methods

MEDLINE, EMBASE and the Cochrane Library were searched according to the PRISMA guidelines in September 2017. The rate and timing of return to play was assessed. The rehabilitation protocols were recorded, including time to start range of motion, partial weight-bearing and complete weight-bearing.

Results

Fifty-seven studies with 3072 ankles were included, with a mean age of 36.9 years (range 23–56.8 years), and a mean follow-up of 46.0 months (range 1.5–141 months). The mean rate of return to play was 86.8% (range 60–100%), and the mean time to return to play was 4.5 months (range 3.5–5.9 months). There was large variability in the reported rehabilitation protocols. Range of motion exercises were most often allowed to begin in the first week (46.2%), and second week postoperatively (23.1%). The most commonly reported time to start partial weight-bearing was the first week (38.8%), and the most frequently reported time of commencing full weight-bearing was 6 weeks (28.8%). Surgeons most often allowed return to play at 4 months (37.5%).

Conclusions

There is a high rate of return following BMS for OLT with 86.8% and the mean time to return to play was 4.5 months. There is also a significant deficiency in reported rehabilitation protocols, and poor quality reporting in return to play criteria. Early weightbearing and early postoperative range of motion exercises appear to be advantageous in accelerated return to sports.

Level of Evidence

Level IV.
Appendix
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Metadata
Title
High reported rate of return to play following bone marrow stimulation for osteochondral lesions of the talus
Authors
Eoghan T. Hurley
Yoshiharu Shimozono
Niall P. McGoldrick
Charles L. Myerson
Youichi Yasui
John G. Kennedy
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-4913-7

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