| 1 | Scaffolds based therapy for osteochondral lesions of the talus:A systematic review显示文摘AIM To clarify the effectiveness of scaffold-based therapy for osteochondral lesions of the talus(OLT). METHODS A systematic search of MEDLINE and EMBASE databases was performed during August 2016 and updated in January 2017. Included studies were evaluated with regard to the level of evidence(LOE) and quality of evidence(QOE) using the Modified Coleman Methodology Score. Variable reporting outcome data, clinical outcomes, and the percentage of patients who returned to sport at previous level were also evaluated. RESULTS Twenty-eight studies for a total of 897 ankles were included; 96% were either LOE Ⅲ or Ⅳ. Studies were designated as either of poor or fair quality. There were 30 treatment groups reporting six different scaffold repair techniques: 13 matrix-induced autologous chondrocyte transplantation(MACT), nine bone marrow derived cell transplantation(BMDCT), four autologous matrixinduced chondrogeneis(AMIC), and four studies of other techniques. The categories of general demographics(93%) and patient-reported outcome data(85%) were well reported. Study design(73%), imaging data(73%), clinical variables(49%), and patient history(30%) were also included. The weighted mean American Orthopaedic Foot and Ankle Society(AOFAS) score at final follow-up was: 86.7 in MACT, 88.2 in BMDCT, and 82.3 in AMIC. Eight studies reported that a weighted mean of 68.3% ofpatients returned to a previous level of sport activity. CONCLUSION Scaffold-based therapy for OLT may produce favorable clinical outcomes, but low LOE, poor QOE, and variability of the data have confounded the effectiveness of this treatment. | Yoshiharu Shimozono Youichi Yasui Andrew W Ross Wataru Miyamoto John G Kennedy | 2017 | World Journal of Orthopedics2017，8，10： | 4 |
| 5 | Systematic review of bone marrow stimulation for osteochondral lesion of talus-evaluation for level and quality of clinical studies显示文摘AIM To clarify the quality of the studies indicating lesion size and/or containment as prognostic indicators of bone marrow stimulation(BMS) for osteochondral lesions of the talus(OLT). METHODS Two reviewers searched the Pub Med/MEDLINE and EMBASE databases using specific terms on March 2015 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. Predetermined variables were extracted for all the included studies. Level of evidence(LOE) was determined using previously published criteria by the Journal of Bone and Joint Surgery and methodological quality of evidence (MQOE) was evaluated using the Modified Coleman Methodology Score. RESULTS This review included 22 studies. Overall, 21 of the 22(95.5%) included studies were level Ⅳ or level Ⅲ evidences. The remaining study was a level Ⅱ evidence. MQOE analysis revealed 14 of the 22(63.6%) included studies having fair quality, 7(31.8%) studies having poor quality and only 1 study having excellent quality. CONCLUSION The evidence supporting the use of lesion size and containment as prognostic indicators of BMS for OLTs has been shown to be of low quality. | Youichi Yasui Laura Ramponi Dexter Seow Eoghan T Hurley Wataru Miyamoto Yoshiharu Shimozono John G Kennedy | 2017 | World Journal of Orthopedics2017，8，12： | 0 |
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