Behandlungsstrategien bei osteochondralen Lasionen des Talus [Treatment strategies for osteochondral defects of the talar dome: a systematic review] Struijs P A, Tol J L, Bossuyt P M, Schuman L, van Dijk C N Authors' objectives To compare the results of different treatment strategies for osteochondral defects of the talus. Searching MEDLINE (from 1966 to June 2000), EMBASE (from 1988 to May 2000), CINAHL (from 1982 to March 2000) and Current Contents (until June 2000) were searched. The keywords were provided in the review. There were no language restrictions. The reference lists of selected articles were also searched for additional studies. Study selection Study designs of evaluations included in the review Only case reports were explicitly excluded from the review. The eligible studies had to have a follow-up of at least 6 months. The exact study designs of the included studies were not reported, but none of the studies randomised the patients to the treatment groups. Specific interventions included in the review The treatment strategies eligible for the study were non-operative treatment, excision alone, excision plus curettage, excision plus curettage plus drilling, retrograde drilling, cancellous bone grafting, fixation, and osteochondral transplantation. Studies that applied a mixture of different treatment approaches were excluded from the review. In the included studies, the non-operative treatment comprised the restriction of (sporting) activities, with or without the use of non-steroidal anti-inflammatory drugs, or cast immobilisation for 3 weeks to 4 months. The operative treatment comprised open surgery or arthroscopy. Participants included in the review Patients with acute or chronic osteochondral defects of the talus, who were aged at least 18 years, were eligible for the review. The mean age of the included patients was 26.9 years, 65% were male (35% female), and 18% were military personnel. Forty-two percent of talar dome lesions were lateral and 56% were medial. A history of ankle trauma was reported in 76% of the participants: 93% of those with lateral dome lesions and 61% of those with medial lesions. Outcomes assessed in the review The inclusion criteria specified successful treatment, which was defined as an excellent or good result at follow-up. If the author did not label the success rate, the results were fitted into the score of Thompson and Loomer (see Other Publications of Related Interest no.1). How were decisions on the relevance of primary studies made? Two reviewers independently assessed the articles for inclusion. In case of disagreement, the opinion of a third independent reviewer was decisive. The assessment was blinded in order to prevent bias. Assessment of study quality The authors did not state that they assessed validity. Data extraction The authors did not state how the data were extracted for the review, or how many reviewers performed the data extraction. Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright © 2017 University of York Page: 1 / 4