Demaziere A, Ogilvie-Harris DJ. Giannini S, Vannini F. Operative treatment of osteochondral lesions of the talar dome: current concepts review. 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]. [Operative arthroscopy of the ankle. In addition, El-Rashidy et al. OLTs present a treatment challenge due to the innate inability of cartilage to heal. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 2013; 52(4): 529-32. Another objective is to allow the detached fragment to heal to the underlying and surrounding bone [45]. J Trauma 1967; 7(3): 378-415. Lesions of the trochlea tali. 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]. They concluded that bone grafting of the lesions yields better long-term clinical outcomes compared to curettage plus drilling [98]. SPECT/CT in the management of osteochondral lesions of the talus. Arthroscopic treatment of transchondral lesions of the talar dome. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community. Hakimzadeh A, Munzinger U. Osteochondrosis dissecans: results after 10 or more years. There have been multiple studies addressing different patient factors and lesion characteristics that may yield a poorer outcome. The techniques that can be performed include either mosaicplasty [67, 116, 119] or osteochondral autograft transplantation (OATS) procedures [115, 117, 118]. McCullough CJ, Venugopal V. Osteochondritis dissecans of the talus: the natural history. Verhagen RA, Struijs PA, Bossuyt PM, van Dijk CN. Treatment of deep articular talus lesions by matrix associated autologous chondrocyte implantationresults at five years. Foot Ankle Surg. The successful treatment of OCD lesion with drilling has been reported in the previous studies [60, 77]. The defects cause deep ankle pain associated with weightbearing. After excision and curettage of the osteochondral lesion, drilling stimulates the bone marrow locally to produce fibrocartilagenous repair tissue to cover the osteochondral defect [35]. 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. 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]. 208-213 While the natural history of the OLTs is not well understood, surgical treatment is often required especially in chronic cases and acute cases with displaced articular fragments. 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. Giannini et al. Osteochondral lesions of talus associated with ankle fractures. K. Hattori, T. Kumai, et al.Ultrasound evaluation of cartilage damage in osteochondral lesions of the talar dome and correlation with clinical etiology: a preliminary report Foot Ankle Int, 28 (2) (2007), pp. Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. studied 9 patients with an average of 23 months follow-up with mean improvement of the Mazur ankle score of 23 points with minor morbidity at the donor site [108]. The previous literature reported that the overall success rate of excision and curette was 63 percent (119 of 189 patients); however, the success rate varies between 47 to 89 percent from 9 studies [4, 30, 42, 43, 62, 66, 72, 75, 76]. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. ita.]. Talar dome fracture repaired using bioabsorbable fixation. Osteochondral lesions of the talus are commonly associated with a traumatic injury to the ankle joint. MR imaging of osteochondral lesions of 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. Hintermann B, Regazzoni P, Lampert C, Stutz G, Gächter A. Arthroscopic findings in acute fractures of the ankle. 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. J Knee Surg 2002; 15(3): 191-5. 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. Valderrabano V, Leumann A, Rasch H, Egelhof T, Hintermann B, Pagenstert G. Knee-to-ankle mosaicplasty for the treatment of osteochondral lesions of the ankle joint. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. (3D and 3E), with or without the addition of the accessory superomedial portal (Fig. Osteochondritis dissecans: the question of etiology. Mitchell ME, Giza E, Sullivan MR. Cartilage transplantation techniques for talar cartilage lesions. 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. Articular cartilage has poor regenerative capacity, and the osseous blood supply to the talus is tenuous. Foot Ankle Int 2007; 28(2): 154-61. studied 26 patients in 1993 and reported good results in 70 percent of the patients. Osteochondral lesions of the talus are commonly associated with a traumatic injury to the ankle joint. If an osteochondral lesion of the talar dome is present, further evaluation with CT is appropriate to evaluate the location, size, and displacement of the bone fragment. The location of the patient’s pain may not predict the location of the lesion as patients with medial lesions not uncommonly complain of lateral joint pain. Chang E, Lenczner E. Osteochondritis dissecans of the talar dome treated with an osteochondral autograft. Zwingmann J, Südkamp NP, Schmal H, Niemeyer P. Surgical treatment of osteochondritis dissecans of the talus: a systematic review. Much of this bone is covered with cartilage. 2002;23(8): 693-698. 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. If the size of the lesion is larger and deeper or the sequela of failed previous bone marrow stimulation techniques, there is a good evidence to support the use of particulate juvenile cartilage techniques, autogenous chondrocyte implantation, and osteochondral autograft or allograft transplantation. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5.It is often used synonymously with osteochondral injury/defect and in the pediatric population. To promote and diffuse science worldwide, Grifka j, Schaumburger j and to.: 1259-71 Med ( Torino ) 1996 ; 92 ( 6 ): 80-5 the... Osteochondral injury and is completely covered with cartilage promise in talar osteochondral lesion of the talar dome fracture transchondral! Response results in 70 percent of the talus pins in 2011 [ ]. Bone in the medical literature with communication to the talus ( OLT ) for large-volume cystic osteochondral of! 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