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Meta-Analysis
. 2022 Apr-Jun;13(2):19476035221102569.
doi: 10.1177/19476035221102569.

Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic Injuries: A Systematic Review and Meta-Analysis

Jari Dahmen  1   2   3   4   5   6   7 , Sohaib Jaddi  1   2   3 , Noortje C Hagemeijer  1   2   3   4 , Bart Lubberts  4 , Inger N Sierevelt  1   2   3   8   9 , Sjoerd A S Stufkens  1   2   3 , Pieter d'Hooghe  5 , John G Kennedy  6 , James D F Calder  7   10 , Christopher W DiGiovanni  11 , Gino M M J Kerkhoffs  1   2   3
Affiliations
Meta-Analysis

Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic Injuries: A Systematic Review and Meta-Analysis

Jari Dahmen et al. Cartilage. 2022 Apr-Jun.

Abstract

Objective: To determine and compare the incidence rate of (osteo)chondral lesions of the ankle in patients with acute and chronic isolated syndesmotic injuries.

Design: A literature search was conducted in the PubMed (MEDLINE) and EMBASE (Ovid) databases from 2000 to September 2021. Two authors independently screened the search results, and risk of bias was assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria. Studies on acute and chronic isolated syndesmotic injuries with pre-operative or intra-operative imaging were included. The primary outcome was the incidence rate with corresponding 95% confidence intervals (CIs) of (osteo)chondral lesions of the ankle in combined and separate groups of acute and chronic syndesmotic injuries. Secondary outcomes were anatomic distribution and mean size of the (osteo)chondral lesions.

Results: Nine articles (402 syndesmotic injuries) were included in the final analysis. Overall (osteo)chondral lesion incidence was 20.7% (95% CI: 13.7%-29.9%). This rate was 22.0% (95% CI: 17.1-27.7) and 24.1% (95% CI: 15.6-35.2) for acute and chronic syndesmotic injuries, respectively. In the combined acute and chronic syndesmotic injury group, 95.4% of the lesions were located on the talar dome and 4.5% of the lesions were located on the distal tibia. (Osteo)chondral lesion size was not reported in any of the studies.

Conclusions: This meta-analysis shows that (osteo)chondral lesions of the ankle are present in 21% of the patients with isolated syndesmotic injuries. No difference in incidence rate was found between the different syndesmotic injury types and it can be concluded that the majority of lesions are located on the talar dome.

Prospero registration number: CRD42020176641.

Keywords: ankle; incidence rate; isolated syndesmotic injuries; meta-analysis; osteochondral lesion.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Literature selection algorithm—preferred reporting items for systematic reviews and meta-analyses (PRISMA).
Figure 2.
Figure 2.
Forest plot of overall summarized incidence rate of (O)CLs of the ankle in all types of isolated syndesmotic injuries. CI = confidence interval; (O)CL = (Osteo)Chondral Lesion..
Figure 3.
Figure 3.
Forest plot of the separate incidence rates of (O)CLs of the ankle in acute and chronic isolated syndesmotic injuries. CI = confidence interval; (O)CL = (Osteo)Chondral Lesion.
See this image and copyright information in PMC

References

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