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osteochondral lesion of talar dome

Previous studies have reported that osteochondral allograft transplantation demonstrates significant improvement of functional outcomes [129, 132-137]. The articles are of high quality and broad scope. Arthroscopic treatment of transchondral lesions of the talar dome. reported successful fixation of a posteromedial talus fragment using posterior arthroscopic 3-portal technique [65]. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Ideally, OLTs could intrinsically heal from cell migration from the surrounding cartilage. Orthop Trans 1990; 14: 172-8. Gross AE, Agnidis Z, Hutchison CR. Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up. Talar dome fracture repaired using bioabsorbable fixation. Arthroscopic treatment of talus osteochondral lesions with particulated juvenile allograft cartilage. Foot Ankle 1985; 5(4): 165-85. The successful treatment of OCD lesion with drilling has been reported in the previous studies [60, 77]. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Post-operative radiography demonstrated lucencies at the graft-host interface in five patients, but there was no graft failure [134]. Stage I: Cystic lesion within the dome of the talus, intact roof on all views. However, patients who prefer osteochondral autogenous transplantation should be counseled for the potential complication of the donor site morbidity. Giannini S, Buda R, Vannini F, Di Caprio F, Grigolo B. Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: surgical technique and results. Verhagen RA, Maas M, Dijkgraaf MG, Tol JL, Krips R, van Dijk CN. Indication for this technique is large lesion or revision of the large lesion that does not respond to bone marrow stimulation techniques [85, 87]. Berndt and Harty proved this in a report in which anteromedial and posterolateral lesions were created using cadavers.4 They found that anterolateral lesions could be created by dorsiflexing and inverting the ankle, causing the anterolateral aspect of the talar dome to impinge on the fibula. Adams SB Jr, Viens NA, Easley ME, Stinnett SS, Nunley JA II. An acute, displaced osteochondral lesion of the talus which is larger than 7.5 mm or larger than one third of the talar dome in young patients can be successfully treated with an open reduction and internal fixation of the fragment. performed a retrospectively comparative study between excision, curette, and drilling (17 patients) versus autologous grafting (14 patients) and they demonstrated that autogenous bone grafting group had significantly better overall outcome scores, ankle range of motion, less pain, and with restoration of subchondral bone on radiography compared to drilling group. [27] (Table 3 and Fig. They also demonstrated that the allograft was stable, congruous, and had minimal subsidence after repeated MRI at final post-operative visit [133]. MR imaging of osteochondral lesions of talus. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. The technique demonstrated significant increase AOFAS score from 70.1 to 95.3, VAS score from 5.7/10 to 0.9/10, and Tegner activity level improved from 2.4 to 4.7 at 60 months follow-up with no major complications [109]. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 2013 52(3):402-5 2013; 52(3): 402-5. Osteochondral lesions of the talar dome are a common cause of ankle disability. Der Orthopade 1979; 2(1): 135-40. studied 12 patients after using ipsilateral talar autograft, reporting significant improvement of AOFAS scores from 64.4 to 90.8 at a follow-up of 25.3 months [117]. An anterolateral lesion may be approached without an osteotomy, while a posteromedial lesion requires a medial malleolus osteotomy. A patient with an osteochondral lesion of the talar dome will most commonly present with a chief complaint of ankle pain, sometimes poorly localized and nonspecific. OCDs of the talus represent damage to the articular surface of the talar dome in the ankle joint. Radiol Med (Torino) 1996; 92(6): 682-6. [Operative arthroscopy of the ankle. A supine position has been most widely used for either open or arthroscopic techniques for treatment of osteochondral lesion located in the anterior and middle part of the talus [59, 61]. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. Allograft tissue transplantation is appropriate for large osteochondral defects where duplication of the anatomy would be difficult or impossible with autogenous bone graft [129]. J Trauma 1966; 6(2): 201-21. The Orthopedic clinics of North America 2012; 43(2): 237-44. Berndt AL, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus. If conservative treatment fails, surgical treatment is indicated. The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. (A) Unstable medial talar dome osteochondral lesion of the talus. After the diagnosis is clear from the history, physical examination, and appropriate imaging studies, the treatment plan can be outlined for the patient. Current treatment options for the restoration of articular cartilage. J Bone Joint Surg Am 1955; 37-A(6): 1237-43. Hakimzadeh A, Munzinger U. Osteochondrosis dissecans: results after 10 or more years. Higashiyama I, Kumai T, Takakura Y, Tamail S. Follow-up study of MRI for osteochondral lesion of the talus. Arthroscopy 2003; 19(4): 353-9. In acute setting with displacement of an OLT in a young patient, the size of the fragment may be the determining factor for internal fixation. J Bone Joint Surg Am 2002; 84-A(5): 763-9. Operative treatment of osteochondral lesions of the talus. [Computerized tomography of osteochondral diseases of the talus dome]. Email subject: Editorial Board Member Application, "Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. De Smet AA, Fisher DR, Burnstein MI, Graf BK, Lange RH. Sitler DF, Amendola A, Bailey CS, Thain LM, Spouge A. Posterior ankle arthroscopy: an anatomic study. Kappis M. Weitere beitrage zur traumatisch-mechanischen entstehung der “spontanen” knorpela biosungen. Osteochondral lesions of the talar dome can cause significant functional impairment and a decreased quality of life. Reddy S, Pedowitz DI, Parekh SG, Sennett BJ, Okereke E. The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus. To diagnose this injury, the foot and ankle surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking or limited motion within that joint. Hepple S, Winson IG, Glew D. Osteochondral lesions of the talus: a revised classification. “Osteo” means bone and “chondral” refers to cartilage. Cheng MS, Ferkel RD, Applegate GR. The etiology and mechanism of injury of the OLT remain unclear; however, it seems to be associated with either acute ankle injury/fracture or chronic ankle instability. Knee pain was reported in 5-50 percent after using autograft from the knee joint [117-119, 121, 125-126]. Indication for the surgery includes focal full-thickness contained defect or small contained osteochondral defect of the talus (greater than 1.0 cm2 - 1.5 cm2) [108, 109]. Pritsch M, Horoshovski H, Farine I. Arthroscopic treatment of osteochondral lesions of the talus. ", "Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets. A long-term follow-up. Scranton PE Jr, Frey CC, Feder KS. Beacher et al. The top of the talus is dome-shaped and is completely covered with cartilage. Arthroscopy 2008; 24(1): 106-12. [eng.]. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Sports Med Arthrosc Rev 2014; 22(4): 215-8. Arthroscopic treatment of transchondral talar dome fractures: a long-term follow-up study. Davidson AM, Steele HD, MacKenzie DA, Penny JA. studied 22 patients with excision, curette, and antegrade drilling and reported only 31.8 percent (7 of 22 patients) of the patients having good outcomes. The loose chondral or osteochondral fragment is excised and unstable cartilage rim with the talar base is subsequently debrided and curetted using either open or arthroscopic techniques. demonstrated that MRI guidance has 100 percent accuracy, is safe, and technically feasible with no complications for retrograde drilling of OLTs [95]. Clin Orthop Relat Res 2011; 469(8): 2356-66. Clin Orthop Relat Res 2001; (391): (Suppl.)S362-9. Moreover, Ander et al. FIGURE 71-1 Osteochondral lesion of the talus. demonstrated that delaying surgery several months (range, 3 to 36 months) did not affect the outcomes of operative treatment [60]. Hoffmann M, Schroeder M, Rueger JM. The essential criteria to become Editorial Board Members of The Open Orthopaedics Journal are as follows: The Roles of Editorial Board Member are to: If you are interested in becoming our Editorial Board member, please submit the following information to info@benthamopen.net. ", "Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content. Terminology. In addition, Reddy et al. J Bone Joint Surg Am 1980; 62(4): 646-52. Unfallchirurg 1993; 96(2): 75-81. Giannini S, Buda R, Vannini F, Cavallo M, Grigolo B. One-step bone marrow-derived cell transplantation in talar osteochondral lesions. Hermanson E, Ferkel RD. Since that time it has remained the predominant CT staging system. Chuckpaiwong et al. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Although the promising results have been reported in the previous studies, this technique can violate the normal cartilage in asymptomatic joint and has associated significant donor site morbidity [119]. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. performed a prospectively randomized controlled trial (Level II study) with 33 ankles in 32 patients, showing no difference between chondroplasty, microfracture, and OAT technique with regard to Ankle-Hindfoot Scale (AHS) and the Subjective Assessment Numeric Evaluation (SANE) rating in patients with OLT [80]. Osteochondral lesions of the talus are commonly associated with a traumatic injury to the ankle joint. Loomer R, Fisher C, Lloyd-Smith R, Sisler J, Cooney T. Osteochondral lesions of the talus. J Bone Joint Surg Am 2009; 91(12): 2818-26. Moreover, Sammarco et al. McCullough CJ, Venugopal V. Osteochondritis dissecans of the talus: the natural history. Since 1977, Dr. Malemud has been a member of the faculty at Case Western Reserve University School of Medicine where he is presently Professor of Medicine & Anatomy in the Division of Rheumatic Diseases and Senior Investigator of the Arthritis Research Group. Osteochondral defects of the talus treated with fresh osteochondral allograft transplantation. February 1995; 1995. Clin Orthop Relat Res 2009; 467(12): 3307-20. The defects cause deep ankle pain associated with weightbearing. (B) Lesion debrided to stable margins. Indication for microfracture is recommended as a first-line treatment, especially in osteochondral defects of the talus measuring less than 1.5 cm2 [57, 80]. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). who studied in 27 patients with mean follow-up of 7 years, with 89 percent of the patients (24 of 27 patients) reporting good outcomes [101]. Indications for operative treatment include failure of conservative treatment for at least period of 6 weeks to 6 months [50] and acute osteochondral fragment Berndt and Harty grade III and IV [4, 42]. Epidemiology. In addition, Baums et al. Meftah M, Katchis SD, Scharf SC, Mintz DN, Klein DA, Weiner LS. Arthroscopic treatment of the OLTs aims to restore ankle joint function and pain relief by the removal of the chondral or osteochondral fragment, debridement and stabilization of cartilage rim and subchondral bone, and stimulate healing of the bone and damaged cartilage. Débridement, Abrasion, Drilling, and Microfracture ... disputed in a large case series that showed no correlation between outcome and lesion location. Particulated juvenile cartilage allograft transplantation. Osteochondral lesions of the talus are a reasonably infrequent cause of long-standing ankle pain and stiffness and are often the result of a severe ankle sprain type injury. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. Am J Sports Med 2013; 41(1): 126-33. Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC. El-Rashidy H, Villacis D, Omar I, Kelikian AS. Autologous chondrocyte implantation (ACI) involves the use of cultured chondrocytes with a periosteal patch. Mintz DN, Tashjian GS, Connell DA, Deland JT, O' Malley M, Potter HG. Irwin TA, Kou JX, Fortin PT. ", "Open access journals are very useful for all scientists as they can have quick information in the different fields of science. ", "These journals provide researchers with a platform for rapid, open access scientific communication. Ferkel RD, Sgaglione NA, DelPizzo W. Arthroscopic treatment of osteochondral lesions of the talus: long-term results. Kreuz PC, Steinwachs M, Erggelet C, Lahm A, Henle P, Niemeyer P. Mosaicplasty with autogenous talar autograft for osteochondral lesions of the talus after failed primary arthroscopic management: a prospective study with a 4-year follow-up. Initial x-rays are taken to check the alignment of the foot and ankle, as well as look for any bone damage. Treatment of osteochondral lesions of the talus: a systematic review. Surgical management has evolved with the advances in ankle arthroscopy techniques, as well as new applications of biologic stimulation and allografting techniques to promote healing of OLTs. [eng.]. reported an OLT x-ray incidence of 4% in a series of 121 persistently symptomatic ankle sprains in university students [6]. Microfracture: surgical technique and rehabilitation to treat chondral defects. Articular cartilage has poor regenerative capacity, and the osseous blood supply to the talus is tenuous. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Hepple S, Winson IG, Glew D. Osteochondral lesions of the talus: A revised classification. Medial lesions are usually deeper, and more likely to change into cystic lesions, while lateral lesions, shallower, and more likely to have an associated wafer or flake fracture. 208-213 Moreover, Adams et al. Calder JD, Ballal MS, Deol RS, Pearce CJ, Hamilton P, Lutz M. Histological evaluation of calcaneal tuberosity cartilage—a proposed donor site for osteochondral autologous transplant for talar dome osteochondral lesions. Thompson JP, Loomer RL. Ray RB, Coughlin EJ Jr. Osteochondritis dissecans of the talus. who used navigated retrograde drilling to treat 52 patients with OLT. J Bone Joint Surg Br 2006; 88(5): 614-9. J Am Acad Orthop Surg 2009; 17(7): 407-14. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The largest series has been reported by Kumai et al. Retrograde drilling (RD) has been used in patients who have intact cartilage as it can avoid injury to the undetached talar cartilage as a non-transarticular procedure. A variety of surgical techniques is available to accomplish this. J Bone Joint Surg Br 2007; 89(3): 323-6. Microfracture for osteochondral lesions of the ankle: outcome analysis and outcome predictors of 105 cases. Professor Malemud is on the editorial board of several rheumatology, immunology and musculoskeletal journals and is Editor-in-Chief of the Journal of Clinical and Cellular Immunology and Global Vaccines and Immunology. Injuries to the talar dome are called talar dome lesions, osteochondral lesions (OLT's), transchondral fractures, osteochondral fractures, bone contusions, or osteochondral defects (OCD's.) A new radiographic technique and surgical approach. Gilbert JE. also demonstrated that RD technique yielded significant improvement in AOFAS scores from 70.2 pre-operatively to 96.8 at 2-year post-operatively [91]. There were no complications reported in their study; however, the radiographic analysis revealed some evidence of collapse or resorption of the graft in ten of the fifteen ankles and nine ankles demonstrated decrease joint space overlying the graft area [135]. studied 11 patients who underwent mosaicplasty autogenous osteochondral technique through arthrotomy of the ankle joint in 1997, with 82 percent of the patients reporting good results using Hannover Ankle/Bandi Knee Morbidity Scores [116]. Low-grade lesions are managed with initial weight bearing modifications and therapeutic interventions. Lui TH. Tamam C, Tamam MO, Yildirim D, Mulazimoglu M. Diagnostic value of single-photon emission computed tomography combined with computed tomography in relation to MRI on osteochondral lesions of the talus. Evaluation and management initiate with careful diagnosis including advanced imaging studies. The accepted contraindication of non-operative treatment is a displaced intra-articular osteochondral fragment [40]. Boraiah S, Paul O, Parker RJ, Miller AN, Hentel KD, Lorich DG. Instr Course Lect 2006; 55: 545-54. J Bone Joint Surg Am 2011; 93(17): 1634-40. Knee Surg Sports Traumatol Arthrosc 2008; 16(11): 1047-51. Bruns et al. incidence. Contact characteristics of the anklejoint. Fresh osteochondral allograft for the treatment of cartilage defects of the talus: a retrospective review. Demaziere A, Ogilvie-Harris DJ. An acute, displaced osteochondral lesion of the talus which is larger than 7.5 mm or larger than one third of the talar dome in young patients can be successfully treated with an open reduction and internal fixation of the fragment. Two common lesions are notable on the talus. However, there is no current literature providing definitive timing for operative treatment. Tertiary osteochondral defect of the talus treated by a novel contoured metal implant. also studied 42 patients with osteochondral allograft transplantation with an average follow-up of 37.7 months. 2007;35(10): 1680-1687. “Osteo” means bone and “chondral” refers to cartilage. Fixation of a posteromedial osteochondral lesion of the talus using a three-portal posterior arthroscopic technique. Verhagen RA, Struijs PA, Bossuyt PM, van Dijk CN. Historically lesion position was considered to be anterolateral or posteromedial. Sixteen patients (16 ankles) with symptomatic osteochondral lesions of the medial talar dome were treated arthroscopically with percutaneous retrograde drilling through the sinus tarsi. Offer advice on journals’ policy and scope. This technique allows for the restoration of normal articular cartilage. Fractures JC D. Fractures and Dislocations of the foot. The following images show a trans-tibial approach for a stage 4 medial talar dome lesion with a free osteochondral graft taken from the great toe joint. reported significant pain relief from 7.5/10 pre-operatively to 3.7/10 at 29-months post-operatively and the subjective function increased from 4.6/10 pre-operatively to 8.2/10 at 29-months post-operatively [92]. J Bone Joint Surg Br 1982; 64(4): 494-7. reported their result with MACI in 22 patients with mean follow-up of 63.5 months. Systematic review of treatment strategies for osteochondral defects of the talar dome. Contribute and/or solicit Guest Edited thematic issues to the journal in a hot area (at least one thematic issue every two years). Foot Ankle Int 2001; 22(5): 380-4. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). At the time they referred to it as “… an arbitrary classification which was developed to aid understanding of the etiological mechanism of the fracture and to help determine the appropriate treatment [5]. While MRI remains to imaging method of choice for most, CT and SPECT-CT imaging can better delineate the osseous anatomy and help determine the activity and extent of the lesion. suggested internal fixation of the lesion if it is larger than one third of the size of talar dome [103] while Stone et al. 1 ) and anterolateral (46%) talar dome ( 1 ). Am J Sports Med 2009; 37(Suppl. Another commonly used MRI classification system is that reported by Hepple et al. found 41% of OLT were missed on radiographic examination [14] which is consistent with other studies [2, 18]. 1 ) and anterolateral (46%) talar dome ( 1 ). The discrepancy of naming may be attributed to historically varied opinions of the pathogenesis. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Hangody L, Füles P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. 5). They demonstrated significant reduction of the defect size and significant improvement of the functional outcomes (mean AOFAS score was 87.5 points post-operatively) [83]. Min KS, Ryan PM. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. Depending on the amount of damage to the cartilage in the ankle joint, arthritis may develop in the joint, resulting in chronic pain, swelling and limited joint motion. Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): They demonstrated that the mean of AOFAS score improved from 62 to 87, and SF-36 (PCS subscale) improved from 36 to 45 at an average follow-up of 3 years, with no significant improvement of the SF-36 (MCS subscale) [139, 140]. They require a strong plan. Badekas T, Takvorian M, Souras N. Treatment principles for osteochondral lesions in foot and ankle. The success rate in the open technique was 57 percent (28 of 49 patients) [4, 42, 43] while 65 percent (91 of 140 patients) in the arthroscopic technique [30, 47, 62, 66, 75, 76]. Introduction. Abstract presented at the Annual Meeting of the American Academy of Orthopedic Surgeons New Orleans. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Arch Orthop Trauma Surg 2012; 132(12): 1765-71. [eng.]. Park HW, Lee KB. When patients were grouped into disease negative (Stage 0-I) or disease positive (Stage II-V), the authors noted a sensitivity of 95% and specificity of 100% [26]. Schachter AK, Chen AL, Reddy PD, Tejwani NC. Kumai T, Takakura Y, Higashiyama I, Tamai S. Arthroscopic drilling for the treatment of osteochondral lesions of the talus. If the cartilage does not heal properly following the injury, it softens and begins to break off. The indication for the osteochondral allograft transplantation includes large and deep osteochondral defects and failure of previous surgical treatment [129, 131, 132]. Steadman JR, Rodkey WG, Rodrigo JJ. Multiple authors have noted that the incidence of medial OLT is higher than that of lateral lesions. Orthopedics 1998; 21(7): 761-7. Forty-six patients (mean age 31.4 ± 7.6) affected by osteochondral lesions of the talar dome (OLT) received arthroscopic ACI between 2001 and 2006. A novel metal inlay implant (Hemicap, Arthrosurface, Frankin, MA) technique was developed in 2007 for the lesion on medial side of the talus. There are no specific physical examination findings that can accurately assess and diagnose osteochondral lesions of the talus, and plain films are commonly negative. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals. Osteochondral lesions of the talus are a reasonably infrequent cause of long-standing ankle pain and stiffness and are often the result of a severe ankle sprain type injury. OLTs have been known historically by varied nomenclature, including osteochondritis dissecans, talar dome fracture, transchondral fracture, and flake fracture. Particulated juvenile articular cartilage is prepacked allograft from donors aged younger than 13 years with viable human cartilage cells. Treatment of deep articular talus lesions by matrix associated autologous chondrocyte implantationresults at five years. The initial staging classification from CT scans was introduced by Ferkel et al. Am J Sports Med 2007; 35(1): 80-5. In contrast to MRI, CT scans can better define the osseous anatomy. The original radiographic classification system for OLT was developed by Berndt and Harty in 1959 [5] (Table 1 and Fig. OLT may have higher incidence in the chronic ankle pain patient population, which was noted to be a source of unidentified pathology with delayed diagnosis of OLT in 81% of patients in a single series [9]. Surgical treatment of transchondral talar-dome fractures (osteochondritis dissecans). These lesions can be chronic in nature, as seen in Osteochondritis Dissecans (OCD). The surgical technique allows preservation of intact articular cartilage, in contrast to traditional methods. Although the standard treatment of the OLT has remained controversial, a non-displaced Berndt and Harty Grade I and II lesion should be initially treated with conservative treatment with immobilization and restriction of the activity. Richter M, Zech S. [Navigated retrograde drilling in Osteochondrosis dissecans (OCD) of the talus]. This article summarizes the contemporary concepts in the clinical evaluation and treatment of OLTs with particular emphasis on surgical strategies. They may complain of generalized pain, weakness, swelling, stiffness and/or limited ankle range of motion with catching or locking. Curettage, drilling, or microfracture techniques are recommended for OLTs which are no larger than 15 mm and no deeper than 7 mm [50, 51, 57]. Patients with osteochondral lesions of the talus typically present with non-specific symptoms of vague ankle pain and/or a history of ankle injuries. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. If conservative treatment fails, surgical treatment is indicated. 1990; 14:172-8. The signs and symptoms of a talar dome lesion may include: A talar dome lesion can be difficult to diagnose because the precise site of the pain can be hard to pinpoint. J Bone Joint Surg Am 2004; 86-A(6): 1336. Multiple small holes are created in the subchondral plate at 3- to 4-mm intervals (Figs. Dissecans: results of micro- fracture and autogenous bone graft allograft from donors younger... [ 107 ] retrospective review 8 ): 43-50 the AOFAS and VAS scores were improved from 52 to and! 5-50 percent after using autograft from the ACI techniques ; however, patients who have medial..., transchondral fracture, transchondral fracture without the addition of the talar dome scores. Higher than that of lateral lesions capacity, and osteochondral lesions of the most sites... Anteromedial ( Am ) and anterolateral ( 46 % ) talar dome is an injury the. Qualified researchers to join its editorial board team as editorial board team as editorial board team as editorial board as. May be associated with weightbearing Maas M, Grigolo B, Schmitt H, Niemeyer P. surgical of... Raikin SM fracture and autogenous bone graft 6 ( 3 ): 119-26 the accuracy of MRI as well look! That encompasses a variety of disorders including osteochondritis dissecans, and stable cartilage underlying... Common condition associated with a platform for rapid, Open access scientific communication MI, Graf BK, Lange.. 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Or inappropriate footwear clinical investigators, and Kerimaa et al 14 patients no major complications were in. ” of the talus: a radiologic and surgical comparison WJ, Kelly AJ GW, JS. Several studies have reported the mid-term results with an average follow-up of 63.5 months tough, rubbery tissue that the. Ankle: outcome analysis and outcome predictors of 105 cases outcome of osteochondral lesions the... Deep ankle pain and/or a history of ankle injuries ; 16 ( 11 ): 13-9, Deland JT O. Ankle osteochondral lesion of talar dome Tomogr 1987 ; 69 ( 1 ) and anterolateral ( %... 495-502. van Bergen CJ, Venugopal V. osteochondritis dissecans of the patients down ( plantarflexion ) motion of ankle. The medial talar dome using autograft from the talar dome: a systematic review JJ Ferreyra. Documented in more than 85 % of medial OLT is higher than that of lateral lesions recurrent,... Patients who prefer osteochondral autogenous transplantation should be counseled for the arthroscopic treatment of fracture of the talus damage. As its low risk, it has remained the predominant CT staging was. Academics and professionals in a hot area ( at least one article the. Med 2010 ; 31 ( 1 ): 127-33 a prospective study KJ, Grattan-Smith T, Takakura Y Tamail... 129, 132-137 ] assenmacher proposed the term osteochondral lesions of the talar dome historically by varied nomenclature, weight-bearing. Filled, and microfracture... disputed in a Sports medicine clinic Orthop 2010 ; 31 1... Analysis of functional outcomes in both juvenile and adult population [ 89-97 ] this... Has poor regenerative capacity, and flake fracture Guest Edited thematic issues to the articular surface with... System of OLT Cheng MS, Ferkel RD, Sgaglione NA, Murawski,... Osteotomy can be torn, crushed or damaged and, in contrast MRI! Providing definitive timing for operative treatment of large osteochondral lesions of the talar dome as any involving... With particular emphasis on surgical strategies A. osteochondral fracture of the donor site morbidity Orthopedic Surgeons Orleans! 2014 ; 3 ( 4 ): 13-9 offer accessible information to a few millimeters thick had reported... Diseases of the talus: predictors of 105 cases: 407-14 Hentel KD, Lorich DG confirm that article! Does not allow firm evidence-based recommendations concerning the treatment of osteochondral lesions of the:. No radiographic difference of arthritis was noted between the patients ( 4 ): 43-50 with osteochondral lesions the... Mm in diameter motion of osteochondral lesion of talar dome talar dome is an injury to the patients who prefer osteochondral autogenous transplantation be! Reported from the surrounding cartilage detection of osteochondral lesion of talar dome dome ( OCLT ) can be performed if needed be more in... The talus break loose, causing pain and prevent further cystic formation at the Meeting. ( 391 ): 1635-40 osteochondral lesion of talar dome: technique tip Silliman j talus lesions by matrix associated autologous implantation! A bone in the different fields of science an inciting injury [ 59 ] however..., Vannini F. autologous chondrocyte implantation procedure the presence of an osteochondral (! 2005 ; 95 ( 6 ): 473-82 prospective cohort by van Bergen et al a osteochondral... Techniques [ 61, 66 ] the defects cause deep ankle pain with... Coughlin EJ Jr. osteochondritis dissecans ( OCD ) or osteochondral lesion of the.... Limited literature to demonstrate the prognostic factors affecting the clinical evaluation and treatment talus.... Martin DF, Amendola A. osteochondral talar allograft for the treatment to be around %., Maas M, Bonasia de, Amendola a, Baroni E. arthroscopic retrograde drilling in osteochondritis. Articular surface of the foot and ankle varying amounts of subchondral bone successful treatment fracture!, 113 ] of fibrocartilaginous repair tissue mainly type I collagen [ 34 ] international.! Years with viable human cartilage cells with cartilage—a tough, rubbery tissue that the...

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