Arthroscopic Drilling for the Treatment of Osteochondral Lesions of the Talus*

Treatment of osteochondral defects of the talus

“…322,439 In a large magnetic resonance imaging (MRI) survey of 428 affected ankles, 53% of the lesions were localized centromedially and 26% centrolaterally. 322 In 4% to 7% of patients, the occurrence of the defect is bilateral, 49,69,235 suggesting nontraumatic osteochondritis dissecans. Patients with an OCD are frequently 20-to 30-year-old men.…”

“…If only cartilage is involved in the pathology, the term chondral defect is used. Many synonyms are used, including osteochondritis dissecans, 135 transchondral fracture, 49 flake fracture, 197 talar dome fracture, 30 osteochondral fracture, 19 osteochondral lesion, 235 and osteochondral defect. 346 A differentiation should be made between traumatic and nontraumatic origin (i.e., osteochondritis dissecans).…”

Iatrogenic Osteochondral Kissing Lesion After Transmalleolar Drilling of the Talar Dome

“…4,8 A study by Robinson et al 9 showed that an OCLT often follows an ankle injury with articular damage and that it cannot be viewed in isolation because there will be other associated damage to the joint. The authors compared the transmalleolar drilling procedure with the excision and curettage procedure in OCLTs.…”

“…8 To reach the talar dome lesion, Angermann and Jensen 10 propagated the transmalleolar drilling of the talar dome lesion, if the overlying talar articular cartilage appeared intact. However, a study by Kumai et al 8 showed promising results when a retrograde talar drilling procedure was used. This technique shows a tendency toward healing in talar dome defects while the tibiotalar articular cartilage and surroundings are preserved.…”

Talar Osteochondral Defect Grafting with Nexa Orthopedics OsteoCure Bone Graft Plug

“…In a study by Kumai, et al, the authors found good clinical results in arthroscopic debridement and kwire drilling of lesions in patients who were younger than sixty years old. 6 Posteromedial lesions typically necessitate an osteotomy of the medial malleolus for exposure, with open reduction and internal fixation and subsequent prolonged non weight-bearing. (Fig.…”