An osteochondral injury to the talar dome produces pain at the ankle and you will … Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 4. 5. Mandracchia VJ(1), Buddecke DE Jr, Giesking JL. Talar dome lesions are usually caused by … Epub 2014 Dec 11. 11 Chondral injuries generally occur to either the anterolateral or posteromedial ankle. 2001 Jul. Approximately 10% of osteochondral talar dome lesions … Patients tend to present… Background: Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Talar dome lesions are usually caused by … It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Assenmacher JA, Kelikian AS, Gottlob C. Arthroscopically assisted autologous osteochondral transplantation for osteochondral lesions of the talar dome: an MRI and clinical follow-up study. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Treatment of Osteochondral Lesions of the Talar Dome James W. Stone MD Key Points Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. Talar osteochondral lesions tend to involve the medial and lateral corners of the talar dome. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. OLTs typically are preceded by a traumatic event and generally result in vascular damage to the subchondral bone. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. Mild joint effusion is seen at tibio-talar and subtalar joints. 3. Anderson IF, Crichton KJ, Grattan-Smith T. Osteochondral fractures of the dome of the talus. Foot Ankle Surg. Series shows the case of a 25-years-old man, a sports and physically active patient, with chronic ankle pain, a lateral talus osteochondral lesion (OCL), and chronic ankle instability. Arthroscopy. FIGURE 71-1 Osteochondral lesion of the talus. Talar dome lesions are most common, while talar head lesions are relatively rare. Nelson SC, Haycock DM: Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. ( C ) This corresponds to Zone 4 in the grid proposed by Elias and colleagues, 5 which was found to be the most common location for talar dome lesions and the location of the largest and deepest lesions. Osteochondral lesions of the talar dome. 22(7):544-51. . We have … “Osteo” means bone and “chondral” refers to cartilage. Foot Ankle Int. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). Talar dome lesions are usually caused by an injury, such as an ankle sprain. A comprehensive review with retrospective study. “Osteo” means bone and “chondral” refers to cartilage. 10. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Arthroscopy. The incidence of osteochondral lesions of the talus is increasing because of a greater awareness of this injury following ankle trauma. Particulated juvenile cartilage allograft transplantation. Author information: (1)Broadlawns Medical Center, Des Moines, Iowa, USA. Sixteen patients (16 ankles) with symptomatic osteochondral lesions of the medial talar dome were treated arthroscopically with percutaneous retrograde drilling through the sinus tarsi. in 1984 emphasized that these lesions should not be called as osteochondritis dissecans but be grouped under a broader term “osteochondral lesions of the talar dome.” The arthroscopic treatment of these lesions was first described by Parisien and Pritsch et al. The use of various https://openorthopaedicsjournal.com/VOLUME/11/PAGE/743/FULLTEXT Osteochondral lesions of the talar dome are a common cause of ankle disability. Radiographs showed a suspicious area on the lateral talar dome. Kelberine F, Frank A. Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases. 2015 Sep;21(3):193-7. Etiology of these lesions is debated but trauma seems the most supported etiology. The incidence is similar, but lateral talar dome injuries … … Osteochondral lesion of the talar dome Share | Definition. The recognition of a traumatic etiology has increased our understanding and management of these disorders. It is often associated with a traumatic injury such as a severe ankle sprain. cartilage lesions when evaluated arthroscopically.7 Etiology Many different terms have been used to describe these defects of talar articular cartilage including transchondral fracture, osteochondral fracture, osteochondritis dissecans, talar dome fracture, and flakedfracture. Conservative management, including weight-bearing restrictions, physical therapy, and supportive measures, often is first-line treatment. (A) Sagittal and (B) axial T2-weighted images of the ankle show an osteochondral lesion at the medial talar dome at the equator (midline) of the anteroposterior (AP) dimension. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. Initially, OLT was described and classified as ‘transchondral fractures of the talus’ by Berndt and Harty in 1959 (1) . The lesion’s location does not technically limit the ability to perform the conventional surgical treatments discussed in this chapter as it does other restorative procedures, such as osteochondral autograft or allograft transplantation (i.e., osteoarticular transfer system [OATS]) or autologous chondrocyte implantation (ACI), which require greater access to the talar dome. Free Online Library: Osteochondral lesions of the talar dome. Small well defined hypointense signal lesion is seen on the T1W images in the medial talar dome at subchondral region. 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. Detached osteochondral lesions and loose bodies secondary to osteochondral lesions of the talar dome usually require fragment removal and debridement of the bone bed. Adjacent subtle marrow edema seen in the medial aspect of talus bone. “Osteo” means bone and “chondral” refers to cartilage. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Osteochondral lesions of the talar dome are common problems encountered in orthopaedics. Canale ST, Belding RH: Osteochondral lesions of the talus. (B) Lesion debrided to stable margins. Osteochondral lesion (OCL) of the talar dome is rare in children. “Osteo” means bone and “chondral” refers to cartilage. Management options are as numerous as the terms used to describe these lesions. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). JAPMA 95(1): 91-96, 2005. in 1986. 2. JBJS 62(1): 97-102, 1980. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Medial lesions are more common than the lateral ones and typically located at the posteromedial talar dome, with a typicall deep - cupshaped figure. (A) Unstable medial talar dome osteochondral lesion of the talus. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Outcome of arthroscopic debridement and microfracture as the primary treatment for osteochondral lesions of the talar dome. 2012; 28(12):1902-1907. 9. onnenwerth MP, Roukis TS. The surgical technique allows preservation of intact articular cartilage, in contrast to traditional methods. With regard to the side of the lesion, observations have demonstrated consistently that lateral sided lesions are predominantly post-traumatic and the medial lesions are largely due to atraumatic causes, the results in our study also corroborate with the same findings. Terminology. Osteochondral lesion of the talar dome (OCLT) can be a devastating injury that affects mobility. 73. Medial lesions tend to be deeper and cup shaped. Procedures for the treatment of osteochondral lesions of the talus, including debridement of the joint, shaving of fibrillated cartilage, and resection or perforation of subchondral bone in the last decade, have been performed arthroscopically with very low morbidity. 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. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. All … A medial talar dome injury is seen on a mortise x-ray view. Diagnosis of lesions is based on imaging. Hangody L: The mosaicplasty technique for osteochondral lesions of the talus. Injuries to the talar dome should be suspected when an athlete presents with chronic ankle pain following an injury to the ankle. by "Bulletin of the NYU Hospital for Joint Diseases"; Health, general Anklebone Bone diseases Care and treatment Cartilage Injuries Osteochondritis Osteochondrosis Talus (Anklebone) It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). A classification was proposed by Bemdt and Harty (1959) who found that both the medial and lateral OCL of the talus could be induced by trauma; they named this lesion transchondral fracture. In general, the edges of the lesion are debrided to healthy, well-attached articular cartilage, and the base of the lesion is abraded to viable, bleeding subchondral bone. Talar dome injuries such as osteochondral lesions of the talus (OLT) can occur following an ankle injury, resulting in ongoing residual ankle pain and functional disability. The talus is a bone in the foot that helps form the ankle joint. An osteochondral lesion of the talus (OLT) is defined as an injury to the talar dome that results in partial or total separation of the articular cartilage or subchondral bone. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. Kouvalchouk et al. 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. A partial fluid cleft at its posterior margin and a mild subchondral oedema suggests an unstable lesion. 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