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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)

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

A Letter to the Editor to this article was published on 17 November 2020

Abstract

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 mm2 (range 15–600 mm2) vs. 150 mm2 (range 25–448 mm2)]. 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.

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Abbreviations

AMIC:

Autologous matrix-induced chondrogenesis

AOFAS:

American Orthopedic Foot and Ankle Society

BHL:

Berndt–Harty–Loomer

CAI:

Chronic ankle instability

FAAM:

Foot and Ankle Ability Measure

FAOS:

Foot and Ankle Outcome Score

ICRS:

International Cartilage Repair Society

IRB:

Institutional Review Board

NRS:

Numeric Rating Scale for Pain

OCLA:

Osteochondral lesion of the ankle

OCLT:

Osteochondral lesion of the talus

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Acknowledgments

We want to thank the Deutsche Arthrose-Hilfe e.V. and the Stiftung Oskar-Helene-Heim.

Funding

The German Cartilage Registry is financially supported by the Deutsche Arthrose-Hilfe e.V. and the Stiftung Oskar-Helene-Heim.

Author information

Authors and Affiliations

  1. Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany

    Daniel Körner, Atesch Ateschrang, Steffen Schröter & Marc-Daniel Ahrend

  2. Department of Orthopaedics and Special Trauma Surgery, Klinikum Mittleres Erzgebirge gGmbH, Zschopau, Germany

    Matthias Aurich

  3. International Center of Hip-, Knee- and Foot Surgery, Sport Traumatology, ATOS Clinic Heidelberg, Heidelberg, Germany

    Christoph Becher

  4. Center for Foot and Ankle Surgery, Schön Clinic Munich Harlaching, FIFA Medical Centre, Munich, Germany

    Markus Walther & Oliver Gottschalk

  5. Department of Orthopaedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany

    Yannic Bangert

  6. Department of Orthopaedic Surgery, Diakovere Annastift, Hannover Medical School, Hannover, Germany

    Sarah Ettinger & Christian Plaass

Authors
  1. Daniel Körner
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  2. Atesch Ateschrang
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  6. Markus Walther
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  7. Oliver Gottschalk
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  9. Sarah Ettinger
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Contributions

DK: study design, data acquisition, statistical data analysis and interpretation, drafting and writing the manuscript. AA, MA, SS and CB: study design, revision of the manuscript. MW, OG, YB, SE and CP data acquisition, revision of the manuscript. MDA: study design, statistical data analysis and interpretation, drafting and writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Daniel Körner.

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Conflict of interest

CP is a consultant of Medartis AG. CP has received or will receive research grants not related to this paper from Plasmaconcept, Medartis, Stryker, DePuysSynthes, NewDeal, and OPED. The other authors declare that they have no potential conflict of interest.

Ethical approval

The study was performed according to the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments.

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Körner, D., Ateschrang, A., Schröter, S. et al. 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). Knee Surg Sports Traumatol Arthrosc 28, 3339–3346 (2020). https://doi.org/10.1007/s00167-020-05954-1

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