There is also reactive bone marrow edema of the distal tibia and the talus. (A) Unstable medial talar dome osteochondral lesion of the talus. Clinical management of these lesions is based on whether or not the fragments are attached. Diagnosis. Author information: (1)1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Rm 2A061, 2/F, New Extension Block, Prince of Wales Hospital, 30-32 Ngan Shing St, Shatin, New Territories, Hong Kong, SAR. The talus is a bone in the foot that helps form the ankle joint. Retrograde drilling of osteochondral lesions of the medial talar dome. There is an osteochondral fracture of the posterolateral part of the talar dome; the fractured fragment is detached and flipped upside down, so that the articular cartilage is visible at its inferior surface. Foot Ankle Int 1999; 20:474-480. METHODS: Thirty-three patients (mean age, 35.1 years; body mass index, 26.8) with osteochondral lesions of the medial talar dome were retrospectively evaluated after open AMIC repair at a mean follow-up of 4.7 years (range, 2.3-8.0 years). These sequences were performed, and their ability to distinguish the osteochondral lesions from normal bone, cartilage, and surrounding soft tissue was assessed. Furthermore, the ankle joints of five volunteers without osteochondral lesions of the medial talar dome and one volunteer with an osteochondral lesion of the medial talar dome were imaged. Management of symptomatic osteochondral lesions of the talus (OLT) is challenging given the poor healing potential of articular cartilage. of talar osteochondral lesions. âOsteoâ means bone and âchondralâ refers to cartilage. Nine osteochondral lesions of the talar dome were treated arthroscopically. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. Crossref, Medline, Google Scholar; 12. Osteochondral lesion of the talus in children: Are there MRI ... Keywords Ankle .Children .MRI .OCD .OLT .Osteochondritisdissecans .Osteochondrallesion .Talar dome Introduction Osteochondritis dissecans (OCD) ... 2 Department of Radiology, Children âs Hospital ⦠Osteochondral fractures of the dome of the talus. Patients tend to present⦠OCDs of the talus represent damage to the articular surface of the talar dome in the ankle joint. Retrograde drilling of osteochondral lesions of the medial talar dome. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma; Epidemiology . The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. Most OCD of the talar dome (8a) treated non-operatively improve or show no change on MRI at an average of 13.7 months, and marrow edema and subchondral cysts are not reliable indicators of progression. If the cartilage doesnât heal properly following the injury, it softens and begins to break off. Treatment of Osteochondral Lesions of the Medial Talar Dome with Osteochondral Autograft Transplantation Operative Techniques in Orthopaedics, Vol. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Lee RKL(1), Griffith JF(1), Law EKC(1), Ng AWH(1), Yeung DKW(1). Clin Orthop Relat Res. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Purpose: The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Two patients (a 16-year-old boy) had two recent osteochondral fractures, anterior and superior lateral, with a free fragment detached in the joint. ⦠Talar dome lesions are usually caused by an injury, such as an ankle sprain. âOsteoâ means bone and âchondralâ refers to cartilage. Nine osteochondral lesions of the talar dome were treated arthroscopically. (B) Lesion debrided to stable margins. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. The most common sites are the posteromedial (53%) ( Fig. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. 3 Autogenous bone grafting for the treatment of talar dome lesions Bale RJ, Hoser C, Rosenberger R, Rieger M, Benedetto KP, Fink C. Osteochondral lesions of the talus: computer-assisted retrograde drillingâfeasibility and accuracy in initial experiences. Talar Dome. Smith GR, Winquist RA, Allan NK, Northrop CH. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. The purpose of our research was to evaluate the incidence of osteochondral lesions of the talus (OLT) with peroneal tendon pathologic features according to the magnetic resonance imaging (MRI) findings. A partial fluid cleft at its posterior margin and a mild subchondral oedema suggests an unstable lesion. Talar dome chondral and osteochondral lesions are a common cause of ankle pain and subjective instability. Ankle Traction During MRI of Talar Dome Osteochondral Lesions. Many of these lesions are first diagnosed by plain film. RSNA, 2009 Supplemental material: ... Radiology: Volume 252: ... dral lesion of the medial talar dome were imaged. 1977 Sep; 124 (3):667â673. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). Talar dome lesions are usually caused by ⦠Few studies have evaluated the incidence of talar dome lesions and injuries to the peroneal tendons occurring concomitantly. These sequences were performed, and their ability to distinguish the osteo-chondral lesions from normal bone, carti- The lesionâs 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. They may also be called osteochondritis dessicans or osteochondral fractures. It is often associated with a traumatic injury such as a severe ankle sprain. 17 Osteochondral Lesions of the Talus MARK E. EASLEY, STEVEN D. SIDES, AND ALISON P. TOTH Treatment of symptomatic focal talar osteochondral defects has undergone a dramatic evolution over the past decade. 1976 Jan-Feb;(114):185â191. An osteochondral injury to the talar dome produces pain at the ankle and you will ⦠1, pp. Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. It is relatively prevalent and are an important cause of ankle morbidity. We studied the value of MR imaging in determining the stability of the osteochondral fragments. 2 of 7 Posadzy et al: Staging of Osteochondral Lesions of the Talus Figure 1: Location of the OCL according to the mechanism of trauma. Foot Ankle Int 1999; 20( 8): 474â 480. Crossref, Medline, Google Scholar; 7 Kumai T, Takakura Y, Higashiyama I, Tamai S. Arthroscopic drilling for the treatment of osteochondral lesions of the talus. A medial talar dome injury is seen on a mortise x-ray view. Radiology. Subtle transchondral fractures of the talar dome: a radiological perspective. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. To diagnose this injury, the 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. Two patients (a 16-year-old boy) had two recent osteochondral fractures, a⦠A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Osteochondral lesions may also involve the talar dome, most frequently the medial aspect. Materials and method: This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March ⦠Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. Medline, Google Scholar 20, No. Lesions in the medial third of the talar dome were significantly larger in surface area involvement and deeper than those at the lateral talar dome. 1 ) and anterolateral (46%) talar dome ( 1 ). A similar pattern was subsequently described at the talar dome in 1922 by Kappis and colleagues.3, 4 The etiology of these lesions remains controversial today with numerous proposed biomechanical explanations and causes in the orthopaedic, pediatric, radiology⦠J Bone Joint Surg Am 1999; 81:1229-1235. Talar dome lesions are usually caused by ⦠A talar dome lesion can be difficult to diagnose because the precise site of the pain can be hard to pinpoint. Particulated juvenile cartilage allograft transplantation. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Art. Yvars MF. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). Medial lesions tend to be deeper and cup shaped. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). [1] Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. 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. âOsteoâ means bone and âchondralâ refers to cartilage. The lesions were treated with simple ablation of the loose body. 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