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

  • Eoghan T. Hurley
  • Yoshiharu Shimozono
  • Niall P. McGoldrick
  • Charles L. Myerson
  • Youichi Yasui
  • John G. Kennedy
Ankle

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.

Keywords

Osteochondral lesions Talus Bone marrow stimulation Microfracture Rehabilitation Return to play 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This manuscript is a systematic review and does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

167_2018_4913_MOESM1_ESM.docx (31 kb)
Supplementary material 1 (DOCX 30 KB)
167_2018_4913_MOESM2_ESM.docx (20 kb)
Supplementary material 2 (DOCX 19 KB)

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Eoghan T. Hurley
    • 1
    • 2
  • Yoshiharu Shimozono
    • 1
    • 3
    • 4
  • Niall P. McGoldrick
    • 5
  • Charles L. Myerson
    • 1
    • 6
  • Youichi Yasui
    • 3
  • John G. Kennedy
    • 1
  1. 1.Hospital for Special SurgeryNew YorkUSA
  2. 2.Royal College of Surgeons in IrelandDublinIreland
  3. 3.Department of Orthopaedic SurgeryTeikyo University School of MedicineTokyoJapan
  4. 4.Department of Orthopaedic SurgeryKyoto University Graduate School of MedicineKyotoJapan
  5. 5.Department of Trauma and Orthopaedic SurgerySt. Vincent’s University HospitalDublin 4Ireland
  6. 6.Tulane University School of MedicineNew OrleansUSA

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