{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:25:13Z","timestamp":1787019913831,"version":"build-2736575974"},"reference-count":91,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Traumatol"],"DOI":"10.1186\/s10195-025-00880-9","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:19:23Z","timestamp":1760012363000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Additional cartilage treatment for small defects in chronic ankle instability shows no mid-term benefit and delays recovery: a randomized controlled trial"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3475-126X","authenticated-orcid":false,"given":"Ra\u00fal","family":"Figa Barrios","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0627-6871","authenticated-orcid":false,"given":"Jos\u00e9 Mar\u00eda","family":"Mora-Guix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7060-136X","authenticated-orcid":false,"given":"Pablo Oscar","family":"Roza Miguel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8558-0109","authenticated-orcid":false,"given":"Jes\u00fas","family":"Vila-Rico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"880_CR1","doi-asserted-by":"publisher","first-page":"603","DOI":"10.4085\/1062-6050-447-17","volume":"54","author":"MM Herzog","year":"2019","unstructured":"Herzog MM, Kerr ZY, Marshall SW, Wikstrom EA (2019) Epidemiology of ankle sprains and chronic ankle instability. J Athl Train 54:603\u2013610. https:\/\/doi.org\/10.4085\/1062-6050-447-17","journal-title":"J Athl Train"},{"key":"880_CR2","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1111\/sms.12248","volume":"25","author":"E Kemler","year":"2015","unstructured":"Kemler E, van de Port I, Valkenberg H et\u00a0al (2015) Ankle injuries in the Netherlands: trends over 10\u201325 years. Scand J Med Sci Sports 25:331\u2013337. https:\/\/doi.org\/10.1111\/sms.12248","journal-title":"Scand J Med Sci Sports"},{"key":"880_CR3","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1136\/bjsm.35.2.103","volume":"35","author":"GD McKay","year":"2001","unstructured":"McKay GD, Goldie PA, Payne WR, Oakes BW (2001) Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med 35:103\u2013108. https:\/\/doi.org\/10.1136\/bjsm.35.2.103","journal-title":"Br J Sports Med"},{"key":"880_CR4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3113\/FAI.2007.0005","volume":"28","author":"RD Ferkel","year":"2007","unstructured":"Ferkel RD, Chams RN (2007) Chronic lateral instability: arthroscopic findings and long-term results. Foot Ankle Int 28:24\u201331. https:\/\/doi.org\/10.3113\/FAI.2007.0005","journal-title":"Foot Ankle Int"},{"key":"880_CR5","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1177\/0363546504270566","volume":"33","author":"M Takao","year":"2005","unstructured":"Takao M, Uchio Y, Naito K et\u00a0al (2005) Arthroscopic assessment for intra-articular disorders in residual ankle disability after sprain. Am J Sports Med 33:686\u2013692. https:\/\/doi.org\/10.1177\/0363546504270566","journal-title":"Am J Sports Med"},{"key":"880_CR6","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1177\/03635465020300031601","volume":"30","author":"B Hintermann","year":"2002","unstructured":"Hintermann B, Boss A, Sch\u00e4fer D (2002) Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med 30:402\u2013409. https:\/\/doi.org\/10.1177\/03635465020300031601","journal-title":"Am J Sports Med"},{"key":"880_CR7","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1177\/036354659302100120","volume":"21","author":"I Taga","year":"1993","unstructured":"Taga I, Shino K, Inoue M et\u00a0al (1993) Articular cartilage lesions in ankles with lateral ligament injury. Am J Sports Med 21:120\u2013127. https:\/\/doi.org\/10.1177\/036354659302100120","journal-title":"Am J Sports Med"},{"key":"880_CR8","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1177\/0363546505281813","volume":"34","author":"V Valderrabano","year":"2006","unstructured":"Valderrabano V, Hintermann B, Horisberger M, Fung TS (2006) Ligamentous posttraumatic ankle osteoarthritis. Am J Sports Med 34:612\u2013620. https:\/\/doi.org\/10.1177\/0363546505281813","journal-title":"Am J Sports Med"},{"key":"880_CR9","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s00776-003-0732-9","volume":"9","author":"K Hirose","year":"2004","unstructured":"Hirose K, Murakami G, Minowa T et\u00a0al (2004) Lateral ligament injury of the ankle and associated articular cartilage degeneration in the talocrural joint: anatomic study using elderly cadavers. J Orthop Sci 9:37\u201343. https:\/\/doi.org\/10.1007\/s00776-003-0732-9","journal-title":"J Orthop Sci"},{"key":"880_CR10","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1249\/MSS.0b013e3181ad1e2f","volume":"42","author":"EA Wikstrom","year":"2010","unstructured":"Wikstrom EA, Bishop MD, Inamdar AD, Hass CJ (2010) Gait termination control strategies are altered in chronic ankle instability subjects. Med Sci Sports Exerc 42:197\u2013205. https:\/\/doi.org\/10.1249\/MSS.0b013e3181ad1e2f","journal-title":"Med Sci Sports Exerc"},{"key":"880_CR11","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1016\/j.joca.2014.04.029","volume":"22","author":"T Golditz","year":"2014","unstructured":"Golditz T, Steib S, Pfeifer K et\u00a0al (2014) Functional ankle instability as a risk factor for osteoarthritis: using T2-mapping to analyze early cartilage degeneration in the ankle joint of young athletes. Osteoarthr Cartil 22:1377\u20131385. https:\/\/doi.org\/10.1016\/j.joca.2014.04.029","journal-title":"Osteoarthr Cartil"},{"key":"880_CR12","doi-asserted-by":"publisher","first-page":"354","DOI":"10.2106\/00004623-197961030-00006","volume":"61","author":"KD Harrington","year":"1979","unstructured":"Harrington KD (1979) Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability. J Bone Joint Surg Am 61:354\u2013361","journal-title":"J Bone Joint Surg Am"},{"key":"880_CR13","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1055\/s-2007-971094","volume":"20","author":"P Gross","year":"1999","unstructured":"Gross P, Marti B (1999) Risk of degenerative ankle joint disease in volleyball players: study of former elite athletes. Int J Sports Med 20:58\u201363. https:\/\/doi.org\/10.1055\/s-2007-971094","journal-title":"Int J Sports Med"},{"key":"880_CR14","doi-asserted-by":"publisher","first-page":"1800","DOI":"10.1007\/s11999-008-0543-6","volume":"467","author":"V Valderrabano","year":"2009","unstructured":"Valderrabano V, Horisberger M, Russell I et\u00a0al (2009) Etiology of ankle osteoarthritis. Clin Orthop Relat Res 467:1800\u20131806. https:\/\/doi.org\/10.1007\/s11999-008-0543-6","journal-title":"Clin Orthop Relat Res"},{"key":"880_CR15","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1177\/0363546505284189","volume":"34","author":"V Valderrabano","year":"2006","unstructured":"Valderrabano V, Pagenstert G, Horisberger M et\u00a0al (2006) Sports and recreation activity of ankle arthritis patients before and after total ankle replacement. Am J Sports Med 34:993\u2013999. https:\/\/doi.org\/10.1177\/0363546505284189","journal-title":"Am J Sports Med"},{"key":"880_CR16","doi-asserted-by":"publisher","first-page":"e14","DOI":"10.1136\/bjsm.2004.011676","volume":"39","author":"A Anandacoomarasamy","year":"2005","unstructured":"Anandacoomarasamy A, Barnsley L (2005) Long term outcomes of inversion ankle injuries. Br J Sports Med 39:e14\u2013e14. https:\/\/doi.org\/10.1136\/bjsm.2004.011676","journal-title":"Br J Sports Med"},{"key":"880_CR17","doi-asserted-by":"publisher","first-page":"634","DOI":"10.4085\/1062-6050-46.6.634","volume":"46","author":"BL Arnold","year":"2011","unstructured":"Arnold BL, Wright CJ, Ross SE (2011) Functional ankle instability and health-related quality of life. J Athl Train 46:634\u2013641. https:\/\/doi.org\/10.4085\/1062-6050-46.6.634","journal-title":"J Athl Train"},{"key":"880_CR18","doi-asserted-by":"publisher","first-page":"758","DOI":"10.4085\/1062-6050-49.3.54","volume":"49","author":"MN Houston","year":"2014","unstructured":"Houston MN, Van Lunen BL, Hoch MC (2014) Health-related quality of life in individuals with chronic ankle instability. J Athl Train 49:758\u2013763. https:\/\/doi.org\/10.4085\/1062-6050-49.3.54","journal-title":"J Athl Train"},{"key":"880_CR19","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1177\/0363546513510393","volume":"42","author":"JE Simon","year":"2014","unstructured":"Simon JE, Docherty CL (2014) Current health-related quality of life is lower in former Division I collegiate athletes than in non-collegiate athletes. Am J Sports Med 42:423\u2013429. https:\/\/doi.org\/10.1177\/0363546513510393","journal-title":"Am J Sports Med"},{"key":"880_CR20","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/j.ptsp.2014.10.006","volume":"16","author":"MN Houston","year":"2015","unstructured":"Houston MN, Hoch JM, Gabriner ML et\u00a0al (2015) Clinical and laboratory measures associated with health-related quality of life in individuals with chronic ankle instability. Phys Ther Sport 16:169\u2013175. https:\/\/doi.org\/10.1016\/j.ptsp.2014.10.006","journal-title":"Phys Ther Sport"},{"key":"880_CR21","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.4085\/1062-6050-50.9.01","volume":"50","author":"MN Houston","year":"2015","unstructured":"Houston MN, Hoch JM, Hoch MC (2015) Patient-reported outcome measures in individuals with chronic ankle instability: a systematic review. J Athl Train 50:1019\u20131033. https:\/\/doi.org\/10.4085\/1062-6050-50.9.01","journal-title":"J Athl Train"},{"key":"880_CR22","doi-asserted-by":"publisher","first-page":"3339","DOI":"10.1007\/s00167-020-05954-1","volume":"28","author":"D K\u00f6rner","year":"2020","unstructured":"K\u00f6rner D, Ateschrang A, Schr\u00f6ter S et\u00a0al (2020) Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German cartilage registry (KnorpelRegister DGOU). Knee Surg Sport Traumatol Arthrosc 28:3339\u20133346. https:\/\/doi.org\/10.1007\/s00167-020-05954-1","journal-title":"Knee Surg Sport Traumatol Arthrosc"},{"key":"880_CR23","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1034\/j.1600-0838.2002.02104.x","volume":"12","author":"L Konradsen","year":"2002","unstructured":"Konradsen L, Bech L, Ehrenbjerg M, Nickelsen T (2002) Seven years follow-up after ankle inversion trauma. Scand J Med Sci Sports 12:129\u2013135. https:\/\/doi.org\/10.1034\/j.1600-0838.2002.02104.x","journal-title":"Scand J Med Sci Sports"},{"key":"880_CR24","doi-asserted-by":"publisher","first-page":"742","DOI":"10.4085\/1062-6050-50.3.05","volume":"50","author":"T Hubbard-Turner","year":"2015","unstructured":"Hubbard-Turner T, Turner MJ (2015) Physical activity levels in college students with chronic ankle instability. J Athl Train 50:742\u2013747. https:\/\/doi.org\/10.4085\/1062-6050-50.3.05","journal-title":"J Athl Train"},{"key":"880_CR25","first-page":"556","volume":"14","author":"T Hubbard-Turner","year":"2015","unstructured":"Hubbard-Turner T, Wikstrom EA, Guderian S, Turner MJ (2015) An acute lateral ankle sprain significantly decreases physical activity across the lifespan. J Sports Sci Med 14:556\u2013561","journal-title":"J Sports Sci Med"},{"key":"880_CR26","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1007\/BF00422833","volume":"114","author":"RAW Verhagen","year":"1995","unstructured":"Verhagen RAW, de Keizer G, van Dijk CN (1995) Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg 114:92\u201396. https:\/\/doi.org\/10.1007\/BF00422833","journal-title":"Arch Orthop Trauma Surg"},{"key":"880_CR27","doi-asserted-by":"publisher","first-page":"S411","DOI":"10.1016\/j.otsr.2013.10.009","volume":"99","author":"S Guillo","year":"2013","unstructured":"Guillo S, Bauer T, Lee JW et\u00a0al (2013) Consensus in chronic ankle instability: aetiology, assessment, surgical indications and place for arthroscopy. Orthop Traumatol Surg Res 99:S411\u2013S419. https:\/\/doi.org\/10.1016\/j.otsr.2013.10.009","journal-title":"Orthop Traumatol Surg Res"},{"key":"880_CR28","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198605000-00032","author":"EJ Eyring","year":"1986","unstructured":"Eyring EJ, Guthrie WD (1986) A surgical approach to the problem of severe lateral instability at the ankle. Clin Orthop Relat Res. https:\/\/doi.org\/10.1097\/00003086-198605000-00032","journal-title":"Clin Orthop Relat Res"},{"key":"880_CR29","doi-asserted-by":"publisher","first-page":"581","DOI":"10.2106\/00004623-198870040-00015","volume":"70","author":"J Karlsson","year":"1988","unstructured":"Karlsson J, Bergsten T, Lansinger O, Peterson L (1988) Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J Bone Joint Surg Am 70:581\u2013588","journal-title":"J Bone Joint Surg Am"},{"key":"880_CR30","doi-asserted-by":"publisher","first-page":"46","DOI":"10.3928\/0147-7447-19820101-07","volume":"5","author":"GR Rechtin","year":"1982","unstructured":"Rechtin GR, McCarroll JR, Webster DA (1982) Reconstruction for chronic lateral instability of the ankle: a review of twenty eight surgical patients. Orthopedics 5:46\u201350. https:\/\/doi.org\/10.3928\/0147-7447-19820101-07","journal-title":"Orthopedics"},{"key":"880_CR31","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1177\/036354658801600513","volume":"16","author":"GJ Sammarco","year":"1988","unstructured":"Sammarco GJ, Diraimondo CV (1988) Surgical treatment of lateral ankle instability syndrome. Am J Sports Med 16:501\u2013511. https:\/\/doi.org\/10.1177\/036354658801600513","journal-title":"Am J Sports Med"},{"key":"880_CR32","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1177\/0363546504271058","volume":"33","author":"R Okuda","year":"2005","unstructured":"Okuda R, Kinoshita M, Morikawa J et\u00a0al (2005) Arthroscopic findings in chronic lateral ankle instability. Am J Sports Med 33:35\u201342. https:\/\/doi.org\/10.1177\/0363546504271058","journal-title":"Am J Sports Med"},{"key":"880_CR33","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1177\/107110079902001106","volume":"20","author":"GA Komenda","year":"1999","unstructured":"Komenda GA, Ferkel RD (1999) Arthroscopic findings associated with the unstable ankle. Foot Ankle Int 20:708\u2013713. https:\/\/doi.org\/10.1177\/107110079902001106","journal-title":"Foot Ankle Int"},{"key":"880_CR34","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1302\/0301-620X.78B4.0780562","volume":"78","author":"CN van Dijk","year":"1996","unstructured":"van Dijk CN, Bossuyt PM, Marti RK (1996) Medial ankle pain after lateral ligament rupture. J Bone Joint Surg Br 78:562\u2013567","journal-title":"J Bone Joint Surg Br"},{"key":"880_CR35","first-page":"95","volume":"37","author":"R Lane Smith","year":"2000","unstructured":"Lane Smith R, Trindade MC, Ikenoue T et\u00a0al (2000) Effects of shear stress on articular chondrocyte metabolism. Biorheology 37:95\u2013107","journal-title":"Biorheology"},{"key":"880_CR36","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1016\/S0021-9290(03)00004-6","volume":"36","author":"W Wilson","year":"2003","unstructured":"Wilson W, van Rietbergen B, van Donkelaar C, Huiskes R (2003) Pathways of load-induced cartilage damage causing cartilage degeneration in the knee after meniscectomy. J Biomech 36:845\u2013851. https:\/\/doi.org\/10.1016\/S0021-9290(03)00004-6","journal-title":"J Biomech"},{"key":"880_CR37","doi-asserted-by":"publisher","first-page":"3722","DOI":"10.1007\/s00167-014-3389-3","volume":"24","author":"D Georgiannos","year":"2016","unstructured":"Georgiannos D, Bisbinas I, Badekas A (2016) Osteochondral transplantation of autologous graft for the treatment of osteochondral lesions of talus: 5- to 7-year follow-up. Knee Surg Sports Traumatol Arthrosc 24:3722\u20133729. https:\/\/doi.org\/10.1007\/s00167-014-3389-3","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"880_CR38","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1007\/s00402-014-1969-9","volume":"134","author":"Y Yasui","year":"2014","unstructured":"Yasui Y, Takao M, Miyamoto W, Matsushita T (2014) Simultaneous surgery for chronic lateral ankle instability accompanied by only subchondral bone lesion of talus. Arch Orthop Trauma Surg 134:821\u2013827. https:\/\/doi.org\/10.1007\/s00402-014-1969-9","journal-title":"Arch Orthop Trauma Surg"},{"key":"880_CR39","doi-asserted-by":"publisher","first-page":"2116","DOI":"10.1007\/s00167-017-4591-x","volume":"26","author":"H Li","year":"2018","unstructured":"Li H, Hua Y, Li H et\u00a0al (2018) Treatment of talus osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes. Knee Surg Sports Traumatol Arthrosc 26:2116\u20132122. https:\/\/doi.org\/10.1007\/s00167-017-4591-x","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"880_CR40","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.fcl.2012.12.004","volume":"18","author":"WJ Choi","year":"2013","unstructured":"Choi WJ, Jo J, Lee JW (2013) Osteochondral lesion of the talus. Foot Ankle Clin 18:67\u201378. https:\/\/doi.org\/10.1016\/j.fcl.2012.12.004","journal-title":"Foot Ankle Clin"},{"key":"880_CR41","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1177\/107110079301400110","volume":"14","author":"MP Shea","year":"1993","unstructured":"Shea MP, Manoli A (1993) Osteochondral lesions of the talar dome. Foot Ankle 14:48\u201355. https:\/\/doi.org\/10.1177\/107110079301400110","journal-title":"Foot Ankle"},{"key":"880_CR42","doi-asserted-by":"publisher","first-page":"103068","DOI":"10.1016\/j.otsr.2021.103068","volume":"107","author":"O Barbier","year":"2021","unstructured":"Barbier O, Amouyel T, de l\u2019Escalopier N et\u00a0al (2021) Osteochondral lesion of the talus: what are we talking about? Orthop Traumatol Surg Res 107:103068. https:\/\/doi.org\/10.1016\/j.otsr.2021.103068","journal-title":"Orthop Traumatol Surg Res"},{"key":"880_CR43","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1097\/00003086-199908000-00020","volume":"365","author":"S Nehrer","year":"1999","unstructured":"Nehrer S, Spector M, Minas T (1999) Histologic analysis of tissue after failed cartilage repair procedures. Clin Orthop Relat Res 365:149\u2013162. https:\/\/doi.org\/10.1097\/00003086-199908000-00020","journal-title":"Clin Orthop Relat Res"},{"key":"880_CR44","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1177\/0363546504273510","volume":"33","author":"JW Alford","year":"2005","unstructured":"Alford JW, Cole BJ (2005) Cartilage restoration, part 1. Am J Sports Med 33:295\u2013306. https:\/\/doi.org\/10.1177\/0363546504273510","journal-title":"Am J Sports Med"},{"key":"880_CR45","doi-asserted-by":"publisher","first-page":"79","DOI":"10.2106\/00004623-198062010-00012","volume":"62","author":"T Furukawa","year":"1980","unstructured":"Furukawa T, Eyre DR, Koide S, Glimcher MJ (1980) Biochemical studies on repair cartilage resurfacing experimental defects in the rabbit knee. J Bone Joint Surg Am 62:79\u201389","journal-title":"J Bone Joint Surg Am"},{"key":"880_CR46","doi-asserted-by":"publisher","first-page":"1380S","DOI":"10.1177\/1947603520985182","volume":"13","author":"J Bruns","year":"2021","unstructured":"Bruns J, Habermann C, Werner M (2021) Osteochondral lesions of the talus: a review on talus osteochondral injuries, including osteochondritis dissecans. Cartilage 13:1380S-1401S. https:\/\/doi.org\/10.1177\/1947603520985182","journal-title":"Cartilage"},{"key":"880_CR47","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1177\/0363546517739606","volume":"46","author":"Y Shimozono","year":"2018","unstructured":"Shimozono Y, Coale M, Yasui Y et\u00a0al (2018) Subchondral bone degradation after microfracture for osteochondral lesions of the talus: an MRI analysis. Am J Sports Med 46:642\u2013648. https:\/\/doi.org\/10.1177\/0363546517739606","journal-title":"Am J Sports Med"},{"key":"880_CR48","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1007\/s00167-017-4774-5","volume":"26","author":"D Jiang","year":"2018","unstructured":"Jiang D, Ao Y, Jiao C et\u00a0al (2018) Concurrent arthroscopic osteochondral lesion treatment and lateral ankle ligament repair has no substantial effect on the outcome of chronic lateral ankle instability. Knee Surg Sports Traumatol Arthrosc 26:3129\u20133134. https:\/\/doi.org\/10.1007\/s00167-017-4774-5","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"880_CR49","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.2106\/JBJS.ST.18.00026","volume":"8","author":"J Vega","year":"2018","unstructured":"Vega J, Guelfi M, Malagelada F et\u00a0al (2018) Arthroscopic all-inside anterior talofibular ligament repair through a three-portal and no-ankle-distraction technique. JBJS Essent Surg Tech 8:e25. https:\/\/doi.org\/10.2106\/JBJS.ST.18.00026","journal-title":"JBJS Essent Surg Tech"},{"key":"880_CR50","doi-asserted-by":"publisher","first-page":"2381","DOI":"10.1177\/0363546511416069","volume":"39","author":"C Nery","year":"2011","unstructured":"Nery C, Raduan F, Del Buono A et\u00a0al (2011) Arthroscopic-assisted Brostr\u00f6m\u2013Gould for chronic ankle instability. Am J Sports Med 39:2381\u20132388. https:\/\/doi.org\/10.1177\/0363546511416069","journal-title":"Am J Sports Med"},{"key":"880_CR51","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/j.arthro.2010.02.002","volume":"26","author":"Y Hua","year":"2010","unstructured":"Hua Y, Chen S, Li Y et\u00a0al (2010) Combination of modified Brostr\u00f6m procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthrosc J Arthrosc Relat Surg 26:524\u2013528. https:\/\/doi.org\/10.1016\/j.arthro.2010.02.002","journal-title":"Arthrosc J Arthrosc Relat Surg"},{"key":"880_CR52","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s00402-002-0470-z","volume":"123","author":"T Takahashi","year":"2003","unstructured":"Takahashi T, Nakahira M, Kaho K, Kawakami T (2003) Anatomical reconstruction of chronic lateral ligament injury of the ankle using pedicle tendon of the extensor digitorum longus. Arch Orthop Trauma Surg 123:175\u2013179. https:\/\/doi.org\/10.1007\/s00402-002-0470-z","journal-title":"Arch Orthop Trauma Surg"},{"key":"880_CR53","doi-asserted-by":"publisher","first-page":"2167","DOI":"10.1177\/0363546508319050","volume":"36","author":"WJ Choi","year":"2008","unstructured":"Choi WJ, Lee JW, Han SH et\u00a0al (2008) Chronic lateral ankle instability. Am J Sports Med 36:2167\u20132172. https:\/\/doi.org\/10.1177\/0363546508319050","journal-title":"Am J Sports Med"},{"key":"880_CR54","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03635-5","author":"S Hopewell","year":"2025","unstructured":"Hopewell S, Chan A-W, Collins GS et\u00a0al (2025) CONSORT 2025 statement: updated guideline for reporting randomized trials. Nat Med. https:\/\/doi.org\/10.1038\/s41591-025-03635-5","journal-title":"Nat Med"},{"key":"880_CR55","unstructured":"Haahr M. RANDOM.ORG: True Random Number Service. Retrieved from https:\/\/www.random.org"},{"key":"880_CR56","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1177\/107110079401500701","volume":"15","author":"HB Kitaoka","year":"1994","unstructured":"Kitaoka HB, Alexander IJ, Adelaar RS et\u00a0al (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349\u2013353. https:\/\/doi.org\/10.1177\/107110079401500701","journal-title":"Foot Ankle Int"},{"key":"880_CR57","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/0958-2592(91)90006-W","volume":"1","author":"J Karlsson","year":"1991","unstructured":"Karlsson J, Peterson L (1991) Evaluation of ankle joint function: the use of a scoring scale. Foot 1:15\u201319. https:\/\/doi.org\/10.1016\/0958-2592(91)90006-W","journal-title":"Foot"},{"key":"880_CR58","doi-asserted-by":"publisher","first-page":"197","DOI":"10.3109\/17453674.2012.657579","volume":"83","author":"M C\u00f6ster","year":"2012","unstructured":"C\u00f6ster M, Karlsson MK, Nilsson J-\u00c5, Carlsson \u00c5 (2012) Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS). Acta Orthop 83:197\u2013203. https:\/\/doi.org\/10.3109\/17453674.2012.657579","journal-title":"Acta Orthop"},{"key":"880_CR59","doi-asserted-by":"publisher","first-page":"988","DOI":"10.2106\/00004623-195941060-00002","volume":"41-A","author":"AL Berndt","year":"1959","unstructured":"Berndt AL, Harty M (1959) Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am 41-A:988\u20131020","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"880_CR60","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1136\/ard.32.5.413","volume":"32","author":"P Beighton","year":"1973","unstructured":"Beighton P, Solomon L, Soskolne CL (1973) Articular mobility in an African population. Ann Rheum Dis 32(5):413\u2013418. https:\/\/doi.org\/10.1136\/ard.32.5.413","journal-title":"Ann Rheum Dis"},{"key":"880_CR61","unstructured":"R Core Team (2020) (2019) R: A language and environment for statistical computing. Accessed 1st Apr 2019"},{"key":"880_CR62","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1177\/19476035231161806","volume":"14","author":"M Walther","year":"2023","unstructured":"Walther M, Gottschalk O, Madry H et\u00a0al (2023) Etiology, classification, diagnostics, and conservative management of osteochondral lesions of the talus. 2023 Recommendations of the working group \u201cClinical Tissue Regeneration\u201d of the German Society of Orthopedics and Traumatology. Cartilage 14:292\u2013304. https:\/\/doi.org\/10.1177\/19476035231161806","journal-title":"Cartilage"},{"key":"880_CR63","first-page":"75","volume":"13","author":"L B\u00f6hler","year":"1931","unstructured":"B\u00f6hler L (1931) Diagnosis, pathology, and treatment of fractures of the os calcis. J Bone Joint Surg Am 13:75\u201389","journal-title":"J Bone Joint Surg Am"},{"key":"880_CR64","doi-asserted-by":"publisher","first-page":"68S","DOI":"10.1177\/1071100718781861","volume":"39","author":"PAD van Dijk","year":"2018","unstructured":"van Dijk PAD, Murawski CD, Hunt KJ et\u00a0al (2018) Post-treatment follow-up, imaging, and outcome scores: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot Ankle Int 39:68S-73S. https:\/\/doi.org\/10.1177\/1071100718781861","journal-title":"Foot Ankle Int"},{"key":"880_CR65","doi-asserted-by":"publisher","DOI":"10.1177\/1071100718779393","volume":"39","author":"CJA van Bergen","year":"2018","unstructured":"van Bergen CJA, Baur OL, Murawski CD et\u00a0al (2018) Diagnosis: history, physical examination, imaging, and arthroscopy: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot Ankle Int 39:3S\u20138S. https:\/\/doi.org\/10.1177\/1071100718779393","journal-title":"Foot Ankle Int"},{"key":"880_CR66","doi-asserted-by":"publisher","first-page":"99","DOI":"10.2106\/JBJS.G.00087","volume":"91","author":"K Sugimoto","year":"2009","unstructured":"Sugimoto K, Takakura Y, Okahashi K et\u00a0al (2009) Chondral injuries of the ankle with recurrent lateral instability: an arthroscopic study. J Bone Jt Surg Am 91:99\u2013106. https:\/\/doi.org\/10.2106\/JBJS.G.00087","journal-title":"J Bone Jt Surg Am"},{"key":"880_CR67","doi-asserted-by":"publisher","first-page":"d671","DOI":"10.2741\/Frenkel","volume":"4","author":"SR Frenkel","year":"1999","unstructured":"Frenkel SR (1999) Degradation and repair of articular cartilage. Front Biosci 4:d671. https:\/\/doi.org\/10.2741\/Frenkel","journal-title":"Front Biosci"},{"key":"880_CR68","first-page":"364","volume":"37","author":"J Hertel","year":"2002","unstructured":"Hertel J (2002) Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 37:364\u2013375","journal-title":"J Athl Train"},{"key":"880_CR69","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1055\/s-2008-1025836","volume":"06","author":"H Tropp","year":"1985","unstructured":"Tropp H, Odenrick P, Gillquist J (1985) Stabilometry recordings in functional and mechanical instability of the ankle joint. Int J Sports Med 06:180\u2013182. https:\/\/doi.org\/10.1055\/s-2008-1025836","journal-title":"Int J Sports Med"},{"key":"880_CR70","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1302\/0301-620X.47B4.669","volume":"47","author":"MA Freeman","year":"1965","unstructured":"Freeman MA (1965) Instability of the foot after injuries to the lateral ligament of the ankle. J Bone Joint Surg Br 47:669\u2013677","journal-title":"J Bone Joint Surg Br"},{"key":"880_CR71","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1302\/0301-620X.47B4.678","volume":"47","author":"MA Freeman","year":"1965","unstructured":"Freeman MA, Dean MR, Hanham IW (1965) The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 47:678\u2013685","journal-title":"J Bone Joint Surg Br"},{"key":"880_CR72","doi-asserted-by":"publisher","first-page":"361","DOI":"10.2165\/00007256-200029050-00005","volume":"29","author":"J Hertel","year":"2000","unstructured":"Hertel J (2000) Functional instability following lateral ankle sprain. Sport Med 29:361\u2013371. https:\/\/doi.org\/10.2165\/00007256-200029050-00005","journal-title":"Sport Med"},{"key":"880_CR73","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1123\/jsr.3.1.43","volume":"3","author":"GB Wilkerson","year":"1994","unstructured":"Wilkerson GB, Nitz AJ (1994) Dynamic ankle stability: mechanical and neuromuscular interrelationships. J Sport Rehabil 3:43\u201357. https:\/\/doi.org\/10.1123\/jsr.3.1.43","journal-title":"J Sport Rehabil"},{"key":"880_CR74","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1136\/bjsports-2016-096189","volume":"50","author":"PA Gribble","year":"2016","unstructured":"Gribble PA, Bleakley CM, Caulfield BM et\u00a0al (2016) Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 50:1496\u20131505. https:\/\/doi.org\/10.1136\/bjsports-2016-096189","journal-title":"Br J Sports Med"},{"key":"880_CR75","doi-asserted-by":"publisher","first-page":"2366","DOI":"10.2106\/JBJS.F.00295","volume":"88","author":"CL Saltzman","year":"2006","unstructured":"Saltzman CL, Zimmerman MB, O\u02bcRourke M et\u00a0al (2006) Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis. J Bone Joint Surg Am 88:2366\u20132372. https:\/\/doi.org\/10.2106\/JBJS.F.00295","journal-title":"J Bone Joint Surg Am"},{"key":"880_CR76","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1097\/01.bot.0000246468.80635.ef","volume":"20","author":"TD Brown","year":"2006","unstructured":"Brown TD, Johnston RC, Saltzman CL et\u00a0al (2006) Posttraumatic osteoarthritis: a first estimate of incidence, prevalence, and burden of disease. J Orthop Trauma 20:739\u2013744. https:\/\/doi.org\/10.1097\/01.bot.0000246468.80635.ef","journal-title":"J Orthop Trauma"},{"key":"880_CR77","first-page":"44","volume":"25","author":"CL Saltzman","year":"2005","unstructured":"Saltzman CL, Salamon ML, Blanchard GM et\u00a0al (2005) Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J 25:44\u201346","journal-title":"Iowa Orthop J"},{"key":"880_CR78","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1097\/01.bco.0000192892.19886.fb","volume":"17","author":"W Jackson","year":"2006","unstructured":"Jackson W, McGarvey W (2006) Update on the treatment of chronic ankle instability and syndesmotic injuries. Curr Opin Orthop 17:97\u2013102. https:\/\/doi.org\/10.1097\/01.bco.0000192892.19886.fb","journal-title":"Curr Opin Orthop"},{"key":"880_CR79","doi-asserted-by":"publisher","first-page":"e26330","DOI":"10.1097\/MD.0000000000026330","volume":"100","author":"H Tan","year":"2021","unstructured":"Tan H, Li A, Qiu X et\u00a0al (2021) Operative treatments for osteochondral lesions of the talus in adults. Medicine (Baltimore) 100:e26330. https:\/\/doi.org\/10.1097\/MD.0000000000026330","journal-title":"Medicine (Baltimore)"},{"key":"880_CR80","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120945313","author":"MJ Kraeutler","year":"2020","unstructured":"Kraeutler MJ, Aliberti GM, Scillia AJ et\u00a0al (2020) Microfracture versus drilling of articular cartilage defects: a systematic review of the basic science evidence. Orthop J Sports Med. https:\/\/doi.org\/10.1177\/2325967120945313","journal-title":"Orthop J Sports Med"},{"key":"880_CR81","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1186\/s13018-024-05314-6","volume":"19","author":"L Cheng","year":"2024","unstructured":"Cheng L, Wang X (2024) Advancements in the treatment of osteochondral lesions of the talus. J Orthop Surg Res 19:827. https:\/\/doi.org\/10.1186\/s13018-024-05314-6","journal-title":"J Orthop Surg Res"},{"key":"880_CR82","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1177\/0363546512453302","volume":"41","author":"WJ Choi","year":"2013","unstructured":"Choi WJ, Choi GW, Kim JS, Lee JW (2013) Prognostic significance of the containment and location of osteochondral lesions of the talus. Am J Sports Med 41:126\u2013133. https:\/\/doi.org\/10.1177\/0363546512453302","journal-title":"Am J Sports Med"},{"key":"880_CR83","doi-asserted-by":"publisher","first-page":"16S","DOI":"10.1177\/1071100718779392","volume":"39","author":"CP Hannon","year":"2018","unstructured":"Hannon CP, Bayer S, Murawski CD et\u00a0al (2018) Debridement, curettage, and bone marrow stimulation: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot Ankle Int 39:16S-22S. https:\/\/doi.org\/10.1177\/1071100718779392","journal-title":"Foot Ankle Int"},{"key":"880_CR84","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1007\/s00167-010-1064-x","volume":"18","author":"CN van Dijk","year":"2010","unstructured":"van Dijk CN, Reilingh ML, Zengerink M, van Bergen CJA (2010) Osteochondral defects in the ankle: why painful? Knee Surg Sport Traumatol Arthrosc 18:570\u2013580. https:\/\/doi.org\/10.1007\/s00167-010-1064-x","journal-title":"Knee Surg Sport Traumatol Arthrosc"},{"key":"880_CR85","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1177\/107110070102200504","volume":"22","author":"PE Scranton","year":"2001","unstructured":"Scranton PE, McDermott JE (2001) Treatment of type V osteochondral lesions of the talus with ipsilateral knee osteochondral autografts. Foot Ankle Int 22:380\u2013384. https:\/\/doi.org\/10.1177\/107110070102200504","journal-title":"Foot Ankle Int"},{"key":"880_CR86","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1016\/j.arthro.2006.06.012","volume":"22","author":"M Takao","year":"2006","unstructured":"Takao M, Komatsu F, Naito K et\u00a0al (2006) Reconstruction of lateral ligament with arthroscopic drilling for treatment of early-stage osteoarthritis in unstable ankles. Arthrosc J Arthrosc Relat Surg 22:1119\u20131125. https:\/\/doi.org\/10.1016\/j.arthro.2006.06.012","journal-title":"Arthrosc J Arthrosc Relat Surg"},{"key":"880_CR87","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1530\/EOR-23-0075","volume":"9","author":"M Walther","year":"2024","unstructured":"Walther M, Gottschalk O, Aurich M (2024) Operative management of osteochondral lesions of the talus: 2024 recommendations of the working group \u2018Clinical Tissue Regeneration\u2019 of the German Society of Orthopedics and Traumatology (DGOU). EFORT Open Rev 9:217\u2013234. https:\/\/doi.org\/10.1530\/EOR-23-0075","journal-title":"EFORT Open Rev"},{"key":"880_CR88","doi-asserted-by":"publisher","first-page":"2853","DOI":"10.1177\/03635465211029642","volume":"50","author":"F Migliorini","year":"2022","unstructured":"Migliorini F, Maffulli N, Schenker H et\u00a0al (2022) Surgical management of focal chondral defects of the talus: a Bayesian network meta-analysis. Am J Sports Med 50:2853\u20132859. https:\/\/doi.org\/10.1177\/03635465211029642","journal-title":"Am J Sports Med"},{"key":"880_CR89","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1053\/j.jfas.2020.11.013","volume":"60","author":"H-J Wen","year":"2021","unstructured":"Wen H-J, Zhu S-Y, Tan H-B, Xu Y-Q (2021) Augmented microfracture technique versus microfracture in talar cartilage restoration: a systematic review and meta-analysis. J Foot Ankle Surg 60:1270\u20131279. https:\/\/doi.org\/10.1053\/j.jfas.2020.11.013","journal-title":"J Foot Ankle Surg"},{"key":"880_CR90","doi-asserted-by":"publisher","first-page":"61S","DOI":"10.1177\/1071100718781862","volume":"39","author":"P D\u2019Hooghe","year":"2018","unstructured":"D\u2019Hooghe P, Murawski CD, Boakye LAT et\u00a0al (2018) Rehabilitation and return to sports: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot Ankle Int 39:61S-67S. https:\/\/doi.org\/10.1177\/1071100718781862","journal-title":"Foot Ankle Int"},{"key":"880_CR91","doi-asserted-by":"publisher","first-page":"2721","DOI":"10.1007\/s00167-018-4913-7","volume":"27","author":"ET Hurley","year":"2019","unstructured":"Hurley ET, Shimozono Y, McGoldrick NP et\u00a0al (2019) High reported rate of return to play following bone marrow stimulation for osteochondral lesions of the talus. Knee Surg Sport Traumatol Arthrosc 27:2721\u20132730. https:\/\/doi.org\/10.1007\/s00167-018-4913-7","journal-title":"Knee Surg Sport Traumatol Arthrosc"}],"container-title":["Journal of Orthopaedics and Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10195-025-00880-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s10195-025-00880-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s10195-025-00880-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:19:28Z","timestamp":1760012368000},"score":1,"resource":{"primary":{"URL":"https:\/\/jorthoptraumatol.springeropen.com\/articles\/10.1186\/s10195-025-00880-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":91,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["880"],"URL":"https:\/\/doi.org\/10.1186\/s10195-025-00880-9","relation":{},"ISSN":["1590-9999"],"issn-type":[{"value":"1590-9999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]},"assertion":[{"value":"29 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Committee of the Consorci Sanitari de Terrassa (CEIm no. 01-20-105-055, date: 20 July 2020), and all patients provided their informed consent before inclusion. This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"P.O.R.M. is affiliated with the MBA Institute and the MBA Institute Chair for Clinical and Biomechanical Research of the University of Oviedo. The rest of the authors have no competing interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"67"}}