Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German Cartilage Registry (KnorpelRegister DGOU)

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020-10, Vol.28 (10), p.3339-3346
• Main Authors: Körner, Daniel, Ateschrang, Atesch, Schröter, Steffen, Aurich, Matthias, Becher, Christoph, Walther, Markus, Gottschalk, Oliver, Bangert, Yannic, Ettinger, Sarah, Plaass, Christian, Ahrend, Marc-Daniel
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Ankle; Ankle Injuries - complications; Ankle Injuries - surgery; Arthroplasty, Subchondral - methods; Cartilage; Chondrogenesis; Collagen Type I - administration & dosage; Collagen Type III - administration & dosage; Demographics; Demography; Female; Germany; Humans; Joint Instability - etiology; Joint Instability - surgery; Lesions; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Patients; Quality of Life; Registries; Talus; Talus - surgery; Transplantation, Autologous; Young Adult
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-020-05954-1

Purpose The purpose of this study was to compare patients with osteochondral lesions of the talus (OCLT) with and without concomitant chronic ankle instability (CAI). Methods Data from the German Cartilage Registry (KnorpelRegister DGOU) for 63 patients with a solitary OCLT were used. All patients received autologous matrix-induced chondrogenesis (AMIC) for OCLT treatment. Patients in group A received an additional ankle stabilisation, while patients in group B received AMIC alone. Both groups were compared according to demographic, lesion-related, and therapy-related factors as well as baseline clinical outcome scores at the time of surgery. The Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), and the Numeric Rating Scale for Pain (NRS) were used. Results Patients in group A were older compared to group B [median 34 years (range 20–65 years) vs. 28.5 years (range 18–72 years)]; the rate of trauma-associated OCLTs was higher (89.7% vs. 38.3%); more patients in group A had a previous non-surgical treatment (74.1% vs. 41.4%); and their OCLT lesion size was smaller [median 100 mm 2 (range 15–600 mm 2 ) vs. 150 mm 2 (range 25–448 mm 2 )]. Most OCLTs were located medially in the coronary plane and centrally in the sagittal plane in both groups. Patients in group A had worse scores on the FAOS quality-of-life subscale compared to patients in group B. Conclusion Patients with OCLT with concomitant CAI differ from those without concomitant CAI according to demographic and lesion-related factors. The additional presence of CAI worsens the quality of life of patients with OCLT. Patients with OCLT should be examined for concomitant CAI, so that if CAI is present, it can be integrated into the treatment concept. Level of evidence IV.