Reporting of Morphology, Location, and Size in the Treatment of Osteochondral Lesions of the Talus in 11,785 Patients: A Systematic Review and Meta-Analysis

Overview

Journal Cartilage

Date 2024 Feb 17

PMID 38366391

Authors

Pascal R van Diepen

Frank F Smithuis

Julian J Hollander

Jari Dahmen

Kaj S Emanuel

Sjoerd A S Stufkens

Gino M M J Kerkhoffs

Affiliations

Soon will be listed here.

Abstract

Objective: Uniformity of reporting is a requisite to be able to compare results of clinical studies on the treatment of osteochondral lesions of the talus (OLT). The primary aim of this study was to evaluate the frequency and quality of reporting of size, morphology, and location of OLTs.

Design: A literature search was performed from 1996 to 2023 to identify clinical studies on surgical treatment of OLTs. Screening was performed by 2 reviewers, who subsequently graded the quality using the methodological index for non-randomized studies (MINORS). The primary outcome was the frequency and qualitative assessment of reporting of size, morphology, and location.

Results: Of 3,074 articles, 262 articles were included. This comprised a total of 11,785 patients. Size was reported in 248 (95%) of the articles and was described with a measure for surface area in 83%, however, in 56%, definition of measurement is unknown. Intraclass coefficient (ICC) value for the reliability of size measurement was 0.94 for computed tomography (CT) scan and 0.87 for MRI scan. Morphology was reported in 172 (66%) of the articles and using a classification system in 23% of the studies. Location was reported in 220 (84%) of the studies.

Conclusion: No consensus was found on the reporting of morphology, with non-validated classification systems and different terminologies used. For location, reporting in 9 zones is underreported. Size was well reported and measurements are more reliable for CT compared with MRI. As these prognostic factors guide clinical decision-making, we advocate the development of a standardized and validated OLT classification to reach uniform reporting in literature.

Level Of Evidence: Level III, systematic review.

Citing Articles

Single-Stage All-Arthroscopic Autologous Cancellous Bone Transplantation in Treatment of Cystic Osteochondral Lesion of the Talus.

Hu F, Yang S, Shi W, Liu Z, Guo Q Arthrosc Tech. 2025; 14(2):103208.

PMID: 40041332 PMC: 11873451. DOI: 10.1016/j.eats.2024.103208.

References

Dahmen J, Jaddi S, Hagemeijer N, Lubberts B, Sierevelt I, Stufkens S . Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic Injuries: A Systematic Review and Meta-Analysis. Cartilage. 2022; 13(2):19476035221102569. PMC: 9168886. DOI: 10.1177/19476035221102569. View

Reilingh M, Murawski C, DiGiovanni C, Dahmen J, Ferrao P, Lambers K . Fixation Techniques: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot Ankle Int. 2018; 39(1_suppl):23S-27S. DOI: 10.1177/1071100718781096. View

Becher C, Zuhlke D, Plaas C, Ewig M, Calliess T, Stukenborg-Colsman C . T2-mapping at 3 T after microfracture in the treatment of osteochondral defects of the talus at an average follow-up of 8 years. Knee Surg Sports Traumatol Arthrosc. 2014; 23(8):2406-2412. DOI: 10.1007/s00167-014-2913-9. View

Chien P, Khan K, Siassakos D . Registration of systematic reviews: PROSPERO. BJOG. 2012; 119(8):903-5. DOI: 10.1111/j.1471-0528.2011.03242.x. View

Li H, Hua Y, Li H, Li S, Ma K, Chen S . Treatment of talus osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes. Knee Surg Sports Traumatol Arthrosc. 2017; 26(7):2116-2122. DOI: 10.1007/s00167-017-4591-x. View

Rikken Q, Kerkhoffs G . Osteochondral Lesions of the Talus: An Individualized Treatment Paradigm from the Amsterdam Perspective. Foot Ankle Clin. 2021; 26(1):121-136. DOI: 10.1016/j.fcl.2020.10.002. View

Flynn S, Ross K, Hannon C, Yasui Y, Newman H, Murawski C . Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus. Foot Ankle Int. 2015; 37(4):363-72. DOI: 10.1177/1071100715620423. View

Ramponi L, Yasui Y, Murawski C, Ferkel R, DiGiovanni C, Kerkhoffs G . Lesion Size Is a Predictor of Clinical Outcomes After Bone Marrow Stimulation for Osteochondral Lesions of the Talus: A Systematic Review. Am J Sports Med. 2016; 45(7):1698-1705. DOI: 10.1177/0363546516668292. View

Hepple S, Winson I, Glew D . Osteochondral lesions of the talus: a revised classification. Foot Ankle Int. 1999; 20(12):789-93. DOI: 10.1177/107110079902001206. View

10.

Ahn J, Choi J, Jeong B . Clinical outcomes after arthroscopic microfracture for osteochondral lesions of the talus are better in patients with decreased postoperative subchondral bone marrow edema. Knee Surg Sports Traumatol Arthrosc. 2020; 29(5):1570-1576. DOI: 10.1007/s00167-020-06303-y. View

11.

Choi W, Park K, Kim B, Lee J . Osteochondral lesion of the talus: is there a critical defect size for poor outcome?. Am J Sports Med. 2009; 37(10):1974-80. DOI: 10.1177/0363546509335765. View

12.

Hu Y, Yue C, Li X, Li Z, Zhou D, Xu H . A Novel Medial Malleolar Osteotomy Technique for the Treatment of Osteochondral Lesions of the Talus. Orthop J Sports Med. 2021; 9(3):2325967121989988. PMC: 8237210. DOI: 10.1177/2325967121989988. View

13.

Raikin S, Elias I, Zoga A, Morrison W, Besser M, Schweitzer M . Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int. 2007; 28(2):154-61. DOI: 10.3113/FAI.2007.0154. View

14.

Seo S, Kim J, Seo D, Kim Y, Lee S, Lee H . Osteochondral lesions of the talus. Acta Orthop. 2018; 89(4):462-467. PMC: 6600130. DOI: 10.1080/17453674.2018.1460777. View

15.

Nelson D, Dipaola J, Colville M, Schmidgall J . Osteochondritis dissecans of the talus and knee: prospective comparison of MR and arthroscopic classifications. J Comput Assist Tomogr. 1990; 14(5):804-8. DOI: 10.1097/00004728-199009000-00026. View

16.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339:b2700. PMC: 2714672. DOI: 10.1136/bmj.b2700. View

17.

DAmbrosi R, Maccario C, Serra N, Ursino C, Usuelli F . Relationship between symptomatic osteochondral lesions of the talus and quality of life, body mass index, age, size and anatomic location. Foot Ankle Surg. 2018; 24(4):365-372. DOI: 10.1016/j.fas.2017.04.011. View

18.

DAmbrosi R, Maccario C, Ursino C, Serra N, Usuelli F . The role of bone marrow edema on osteochondral lesions of the talus. Foot Ankle Surg. 2018; 24(3):229-235. DOI: 10.1016/j.fas.2017.02.010. View

19.

Anderson I, Crichton K, Cooper R, Brazier D . Osteochondral fractures of the dome of the talus. J Bone Joint Surg Am. 1989; 71(8):1143-52. View

20.

Weber C, Kerkhoffs G, Dahmen J, Arbab D, Kobbe P, Hildebrand F . [Osteochondral lesions of the talus : Individualized approach based on established and innovative reconstruction techniques]. Unfallchirurg. 2021; 124(4):319-332. DOI: 10.1007/s00113-021-00964-1. View