Arthroscopic Treatment of Chronic Osteochondral Lesions of the Talus

Ferkel, Richard D.; Zanotti, Robert M.; Komenda, Gregory A.; Sgaglione, Nicholas A.; Cheng, Margaret S.; Applegate, Gregory R.; Dopirak, Ryan M.

doi:10.1177/0363546508316773

Cited by 395 publications

(419 citation statements)

References 54 publications

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“…The use of either CT or MRI is recommended for the diagnosis of OCD, but as the subchondral bony defect is the main problem in ankle lesions, 434 CT scans are preferred for preoperative planning because they accurately assess the size of the bony fragment or associated cyst. 129,160 With anterior ankle arthroscopy, vision of only the anterior part of the OCD is initially required. 432 After identification of the anterior border of the defect, it is debrided anteriorly to posteriorly to further expose the defect, followed by microfracturing.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of osteochondral defects of the talus

Bergen

Leeuw

Dijk

2008

Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Mo

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Section: Discussionmentioning

confidence: 99%

“…129,160 Th e range of motion of the ankle joint has been successfully analyzed using stress CT with forced extreme positions in healthy individuals. 402 Using a similar scanning technique in patients with an OCD, van Bergen et al showed that the location of talar OCDs on CT scans of the ankle in full…”

mentioning

confidence: 99%

Treatment of osteochondral defects of the talus

Bergen

Leeuw

Dijk

2008

Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Mo

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“…This is promising as other osteochondral defect treatments with scaffold only [4,8,14] result in the predominant formation of fibrocartilage, which possesses inferior biomechanical properties [6] and would translate to a shorter repair tissue life span [3].…”

Section: Discussionmentioning

confidence: 99%

Oligo[poly(ethylene glycol)fumarate] Hydrogel Enhances Osteochondral Repair in Porcine Femoral Condyle Defects

Hui

Ren

Afizah

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Management of osteochondritis dissecans remains a challenge. Use of oligo[poly(ethylene glycol)fumarate] (OPF) hydrogel scaffold alone has been reported in osteochondral defect repair in small animal models. However, preclinical evaluation of usage of this scaffold alone as a treatment strategy is limited.Questions/purposes We therefore (1) determined in vitro pore size and mechanical stiffness of freeze-dried and rehydrated freeze-dried OPF hydrogels, respectively; (2) assessed in vivo gross defect filling percentage and histologic findings in defects implanted with rehydrated freeze-dried hydrogels for 2 and 4 months in a porcine model; (3) analyzed highly magnified histologic sections for different types of cartilage repair tissues, subchondral bone, and scaffold; and (4) assessed neotissue filling percentage, cartilage phenotype, and Wakitani scores. Methods We measured pore size of freeze-dried OPF hydrogel scaffolds and mechanical stiffness of fresh and rehydrated forms. Twenty-four osteochondral defects from 12 eight-month-old micropigs were equally divided into scaffold and control (no scaffold) groups. Gross and histologic examination, one-way ANOVA, and one-way Mann-Whitney U test were performed at 2 and 4 months postoperatively. Results Pore sizes ranged from 20 to 433 lm in diameter. Rehydrated freeze-dried scaffolds had mechanical stiffness of 1 MPa. The scaffold itself increased percentage of

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“…Ferkel et al [18] found deterioration of clinical scores in up to 35% of patients within 5 years following BMS. Lee et al [19] reported that only 30% of patients had integration of the repair tissue with the surrounding native cartilage at second look arthroscopy 12 months after BMS.…”

Section: Reparative Proceduresmentioning

confidence: 98%

“…Despite successful outcomes following BMS for OLT, it is of increasing concern that deterioration of reparative fibrous cartilage tissue is inevitable over time [18][19][20]. Ferkel et al [18] found deterioration of clinical scores in up to 35% of patients within 5 years following BMS.…”

Section: Reparative Proceduresmentioning

confidence: 99%

Osteochondral lesions of the talus in the athlete: up to date review

Shimozono

Yasui

Ross

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of review Osteochondral lesions of the talus (OLT) are common injuries in athletes. The purpose of this study is to comprehensively review the clinical results and return to sport capacity in athletes following treatment for OLT. Recent findings Reparative procedures, such as bone marrow stimulation, and replacement procedures, such as autologous osteochondral transplantation, provide good clinical outcomes in short-and mid-term follow-up in the athlete. Recently, biological augmentation and scaffold-based therapies have been shown to improve clinical and radiological outcomes in OLT in both the general population and athletes. Summary Most studies are of a low level of evidence. Studies analyzing the return to sport capability in athletes are further lacking. High-level evidence and well-designed clinical trials are required to establish the most effective treatment protocol.

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Arthroscopic Treatment of Chronic Osteochondral Lesions of the Talus

Cited by 395 publications

References 54 publications

Treatment of osteochondral defects of the talus

Treatment of osteochondral defects of the talus

Oligo[poly(ethylene glycol)fumarate] Hydrogel Enhances Osteochondral Repair in Porcine Femoral Condyle Defects

Osteochondral lesions of the talus in the athlete: up to date review

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