Preexisting and treated concomitant ankle instability does not compromise patient-reported outcomes of solitary osteochondral lesions of the talus treated with matrix-induced bone marrow stimulation in the first postoperative year: data from the German Cartilage Registry (KnorpelRegister DGOU)

Abstract

Purpose

The purpose of this study was to compare the subjective ankle function within the first year following matrix-induced bone marrow stimulation (M-BMS) of patients with a solitary osteochondral lesion of the talus (OCLT) with and without concomitant chronic ankle instability (CAI).

Methods

Data from the German Cartilage Registry (KnorpelRegister DGOU) for 78 patients with a solitary OCLT and a follow-up of at least 6 months were included. All patients received M-BMS for OCLT treatment. The cohort was subdivided into patients with OCLT without CAI treated with M-BMS alone (n = 40) and patients with OCLT and CAI treated with M-BMS and additional ankle stabilisation (n = 38). The Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), and the Numeric Rating Scale for Pain (NRS) were used to assess patient-reported outcomes (median (minimum–maximum)).

Results

From preoperatively to 12 months postoperatively, patients with OCLT without CAI treated with M-BMS alone had a significant improvement of all subscales in the FAAM [activity of daily living 64.3 (10–100) to 88.1 (39–100); sports 34.4 (0–100) to 65.6 (13–94), functional activities of daily life 50 (0–90) to 80 (30–100), functional sports 30 (0–100) to 70 (5–100)] and FAOS [pain 61.1 (8–94) to 86.1 (50–100), symptoms 60.7 (18–96) to 76.8 (29–100), activities of daily living 72.1 (24–100) to 91.9 (68–100), sport/recreational activities 30.0 (0–70) to 62.5 (0–95), quality of life 31.3 (6–50) to 46.9 (19–100)]. Within the first year, patients with OCLT and CAI treated with M-BMS and ankle stabilisation also showed significant improvement in the FAAM [activity of daily living 68.8 (5–99) to 90.5 (45–100); sports 32.8 (0–87.5) to 64.1 (0–94), functional activities of daily life 62.5 (25–100) to 80 (60–90), functional sports 30 (0–100) to 67.5 (0.95)] and the FAOS [pain 66.7 (28–92) to 87.5 (47–100), symptoms 57.1 (29–96) to 78.6 (50–100), activities of daily living 80.1 (25–100) to 98.5 (59–100), sport/recreational activities 35.0 (0–100) to 70.0 (0–100), quality of life 25.0 (0–75) to 50.0 (19–94)]. The pain level decreased significantly in both groups. No significant difference was found between both groups regarding the subscales of FAAM, FAOS and the NRS 1 year postoperatively.

Conclusion

Improvements in subjective ankle function, daily life activities and sports activities were observed within the first year following M-BMS. Our results suggest that preexisting and treated ankle instability did not compromise subjective outcome in patients treated with M-BMS in the first postoperative year.

Level of evidence

Level IV.