距骨骨软骨损伤的手术治疗研究进展

Research Progress in Surgical Treatment for Osteochondral Lesions of the Talus

距骨骨软骨损伤(OLT)是距骨关节面或软骨下骨的损伤,是常见的足踝疾病之一,常导致踝关节疼痛、不稳定、骨关节炎和残疾,影响患者的日常生活。儿童及青少年或病变较小的早期OLT常采用保守治疗。保守治疗无效或符合手术指征的OLT需手术治疗,OLT的手术治疗目前分为骨髓刺激术、骨软骨固定术、自体或异体骨软骨移植、自体骨-骨膜移植等。科技的发展催生并促进了生物佐剂和组织工程技术的进展,手术与生物佐剂和组织工程技术的联合应用逐渐成为研究热点,临床可根据患者病情选择不同联合治疗方式,以提高疗效。

Osteochondral lesions of the talus(OLT)refers to the injury of the articular surface or subchondral bone of the talus,which is one of the common ankle and foot diseases.It often leads to pain,instability,osteoarthritis and disability of the ankle joint,affecting the daily life of the patients.For children and adolescents or early OLT with small lesions,conservative treatment is often adopted.Surgical treatment can be selected for OLT with ineffective conservative treatment or meeting the surgical indication.The surgical treatment of OLT is divided into bone marrow stimulation,osteochondral fixation,autologous or allogeneic osteochondral transplantation,autologous bone-periosteal transplantation and so on.The development of science and technology has given birth to and promoted biological adjuvants and tissue engineering technology.The combined use of surgery and biological adjuvants and tissue engineering technology has gradually become a hot spot in current research.Clinically,different combined treatment methods can be selected according to the disease condition to improve the efficacy.