Background:in most cases osteochondral lesions and defects (OHLD) in the ankle joint are the consequences of trauma, and the results of their treatment depend on a number of factors. Some factors are directly related to the area of damage (depth, localization, size), others are connected to the patients age, presence of degenerative changes in the affected joint, comorbidities, body mass index (BMI), etc.Objectives:to develop an effective system for predicting long-term outcomes in patients with ankle joint OHLD.Methods:24 prognostic factors (age, gender, severity of injury, Charlson comorbidity index, BMI, OA stage, size of defect, localization of injury, degree of osteoporosis, contracture, instability, etc.) influence on the long-term (36 ± 4.5 months) treatment outcomes was analyzed by Bayesian probability analysis in 223 patients after ankle joint OHLD. The prognostic coefficient (PC) was calculated by Wald sequential analysis for each prognostic factor and prognostic system was developed for prediction of high, medium or low probability of positive treatment result, which was determined as a functional joint outcome in AOFAS 75 - 100 points.Results:the greatest predictive value for the positive result of OHLD treatment had the following factors: age< 40 years (PC = 8.5); BMI < 25 kg/m2(PC=7.0), time from trauma < 1 year (PC = 4,1); OA stage < II (PC = 7.2); size of OHLD <1.0 cm2; volume <1.5 cm3(PC = 8.0). The prognostic system is based on the calculating of total factors values for individual patients case in points (Σ PC). If Σ PC is less (-20) the probability of achieving a positive joint-saving result is absent; at Σ PC from (-20) to (+40) the probability is medium; and at Σ PC above (+40) probability is high. The accuracy of the prognostic assessment was retrospectively tested with a 95% confidence interval, the accuaracy of predicitive method – 84,17% (76,59-89,62)%.Conclusion:the size and volume of osteochondral damage, BMI, age and time from trauma has the greatest predictive value for the determination of the long-term results of treatment in patients with ankle joint OHLD; use of the developed prognostic method can be used as a basis for the clinical decision making in choosing different approaches in treatment.Disclosure of Interests:None declared
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