Impact of Early Weightbearing after Autologous Osteochondral Transplantation for Osteochondral Lesion of the Talus– A Systematic Review and Meta-Analysis
Category: Sports;n Arthroscopy Introduction/Purpose: The influence of early weightbearing after autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesion of the talus (OLT) remains unclear. We aim to provide a comprehensive systematic review and meta-analysis to determ...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-12-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011424S00317 |
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| Summary: | Category: Sports;n Arthroscopy Introduction/Purpose: The influence of early weightbearing after autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesion of the talus (OLT) remains unclear. We aim to provide a comprehensive systematic review and meta-analysis to determine the impact of early weightbearing on the clinical outcomes of AOT for OLT with secondary aims to review the rate of return to sports and/or activities and complications. Methods: A systematic review of the PubMed, Embase, and The Cochrane Library databases was performed according to the PRISMA guidelines. Publications were divided into Group A where patients were allowed early weightbearing within the first 6 weeks while Group B consisted of patients who were only allowed weightbearing after 6 weeks. Unweighted estimates were calculated instead of quantitative random-effects meta-analysis due to the high heterogeneity and low level of evidence of the included studies. Results: A total of 35 studies with 1457 ankles were included. There were 20 studies in Group A and 15 studies in Group B. Both the AOFAS and VAS scores were not affected by early weightbearing after AOT for OLT. There were also no differences in rate of return to sports and/or activities found although late weightbearers were more likely to have complications compared to early weightbearers (19% vs 8.4%; RR=0.44, 95% CI:0.32-0.61, p< 0.01). Notably, late weightbearers were 1.79 times (RR=0.56, 95% CI:0.13-2.48, p=0.45) more likely to have postoperative ankle stiffness with/without pain. They were also twice more likely to require repeat surgery for the ankle (11.8% vs 5.4%; RR=0.46, 95% CI:0.28-0.73, p=0.001). The commonest cause for repeat surgery was ankle arthroscopy and debridement for postoperative impingement or pain. Conclusion: Early weightbearing after AOT for OLT yielded similarly good clinical outcomes and return to sports and/or daily activities when compared to late weightbearing. Late weightbearers were significantly more likely to suffer from complications and twice as likely to require repeat surgery. |
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| ISSN: | 2473-0114 |