A Review of Osteochondral Lesions of the Talus

Grossman, Jordan P.; Lyons, Michael C.

doi:10.1016/j.cpm.2009.01.003

Cited by 14 publications

(9 citation statements)

References 63 publications

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“…5,13,14,19,23,44 The latter techniques focus on replacement and regeneration of hyaline cartilage. 17,19,21,46 Our proposed surgical technique with cancellous bone grafting with periosteum is also a viable technique performed in large talar cystic defects, offering very good to excellent results. Our technique aimed to restore the articular surface through the use of repair tissue similar to native cartilage, leading to symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

Large Osteochondral Lesions of the Talus Treated With Autologous Bone Graft and Periosteum Transfer

Nikolopoulos¹,

Sergides²,

Safos³

et al. 2019

Foot & Ankle Orthopaedics

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Background: The treatment of large osteochondral lesions of the talus (OLTs) is challenging due to the poor intrinsic reparative capability of the damaged articular cartilage. Autologous transfer of bone and periosteum has been used successfully in the treatment of large defects in animals, and therefore it was believed that this technique might show similar results in humans. The purpose of this study was to assess the outcome of an innovative technique for autologous transplantation of cancellous tibial graft with periosteal transfer in large OLTs. Methods: Forty-one patients (22 females, 19 males), with a mean age of 34.9 years (range, 18-72 years), with a large OLT (>200 mm2) were treated with autologous bone graft and periosteum transfer. OLTs averaging 310 mm2 were identified on a preoperative computed tomography scan. The procedure consisted of malleolar osteotomy, curettage of sclerotic bone, autologous bone graft from the proximal tibia, and transfixion of periosteum over the graft. Outcome measures, including the pain visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Foot & Ankle Disability Index (FADI), were compared between preoperative and 1 and 2 years following surgery. Results: There were significant improvements in VAS pain score from 7.7 before surgery to 1.1 at 1 year after surgery and 0.4 at 2 years or more after surgery. The AOFAS and FADI scores were also significantly improved from 40.3 and 53.3 preoperatively to 95 and 93.2 postoperatively at 1 year and 95 and 93.2 at 2 or more years postoperatively, respectively. Postoperative complications included 2 patients who required removal of medial malleolar osteotomy tension bands due to symptomatic hardware. There were no nonunions or malunions of the osteotomies and no donor site complications. Conclusion: Autologous bone graft and periosteum transfer was an effective treatment for large OLTs leading to significant decreases in pain and improvement in functional scores at more than 2 years after surgery. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

Large Osteochondral Lesions of the Talus Treated With Autologous Bone Graft and Periosteum Transfer

Nikolopoulos¹,

Sergides²,

Safos³

et al. 2019

Foot & Ankle Orthopaedics

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“…Osteochondral lesions of the talar dome are defined as a separation of cartilage and subchondral bone secondary to trauma or vascular insult 12. They may result from acute trauma or chronic repetitive microtrauma.…”

Section: Talar Osteochondral Injuriesmentioning

confidence: 99%

Management of foot and ankle injuries in pediatric and adolescent athletes: a narrative review

Gill¹,

Klingele²

2018

ORR

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In this review, we focus on the treatment of injuries to the foot and ankle in the adolescent athlete. While many injuries in the adolescent foot and ankle are similar to or overlap with their counterparts in the adult population, the anatomy of the adolescent ankle, especially the presence of growth plates, results in different injury patterns in many cases and calls for specific management approaches. We discuss the unique anatomy of the pediatric patient as well as the diagnostic evaluation and treatment of common injuries in the young athlete.

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“…Common symptoms described by patients include generalized ankle pain as well as clicking or catching of the joint during motion. 29 On examination, pain is typically elicited through palpation of the anteromedial or anterolateral edges of the ankle joint, though osteochondral lesions may be present without palpable tenderness. 29 Range of motion may be limited, and dorsiflexion or plantarflexion may cause clicking or catching.…”

Section: Diagnosismentioning

confidence: 99%