Ätiopathogenetische Aspekte der medialen Osteochondrosis dissecans tali

Bruns, J.; Rosenbach, B.; Kahrs, Johannes

doi:10.1055/s-2007-993526

Cited by 26 publications

(15 citation statements)

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“…These results may also provide additional insight for the treatment of osteochondral defects of the talar dome. Bruns and Rosenbach studied the axial load in the ankle and determined that peak pressure tended to be located over the medial talar edge, which the most common location for the occurrence of osteochondral lesions . Additionally, they showed that the contact area within the ankle joint was dependent on the alignment of the hindfoot and the tibia, with varus or valgus alignment shifting the loads to the medial and lateral edges of the talar dome .…”

Section: Discussionmentioning

confidence: 99%

Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Suero

Sabbagh

Westphal

et al. 2015

Journal Orthopaedic Research

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High tibial osteotomy (HTO) is a commonly used surgical technique for treating moderate osteoarthritis (OA) of the medial compartment of the knee by shifting the center of force towards the lateral compartment. Previous studies have documented the effects of HTO on the biomechanics of the knee. However, the effects of the procedure on the contact pressures within the ankle joint have not been as well described. Seven cadavers underwent an HTO procedure with sequential 5˚valgus realignment of the leg up to 15˚of correction. An axial force of up to 550 N was applied and the intraarticular pressure was recorded. Minor valgus realignment of the proximal tibia does not significantly alter the biomechanics of the ankle. However, moderate-to-large changes in proximal tibial alignment result in significantly decreased tibiotalar contact surface area and in changes in intraarticular ankle pressures. These findings are clinically relevant, as they provide a biomechanical rationale for the diagnosis and treatment of ankle symptoms in the setting of lower limb malalignment or after alignment correction procedures. ß

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Section: Discussionmentioning

confidence: 99%

Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Suero

Sabbagh

Westphal

et al. 2015

Journal Orthopaedic Research

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“…The morphological appearance of medial and lateral lesions can be explained by the different forces that are necessary to produce them. Lateral lesions are produced by a tangential shear force across the talar dome, whereas medial lesions are caused by a more perpendicular force, resulting in a deeper lesion that is unlikely to displace from its bed [26].…”

Section: Discussionmentioning

confidence: 99%

Treatment principles for osteochondral lesions in foot and ankle

Badekas

Takvorian²,

Souras

2013

International Orthopaedics (SICOT)

136

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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. A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondral defect. Whether OLT is a precursor to more generalised arthrosis of the ankle remains unclear, but the condition is often symptomatic enough to warrant treatment. In more than one third of cases, conservative treatment is unsuccessful, and surgery is indicated. There is a wide variety of treatment strategies for osteochondral defects of the ankle, with new techniques that have substantially increased over the last decade. The common treatment strategies of symptomatic osteochondral lesions include nonsurgical treatment, with rest, cast immobilisation and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Surgical options are lesion excision, excision and curettage, excision combined with curettage and microfracturing, filling the defect with autogenous cancellous bone graft, antegrade (transmalleolar) drilling, retrograde drilling, fixation and techniques such as osteochondral transplantation [osteochondral autograft transfer system (OATS)] and autologous chondrocyte implantation (ACI). Furthermore, smaller lesions are symptomatic and when left untreated, OCDs can progress; current treatment strategies have not solved this problem. The target of these treatment strategies is to relieve symptoms and improve function. Publications on the efficacy of these treatment strategies vary. In most cases, several treatment options are viable, and the choice of treatment is based on defect type and size and preferences of the treating clinician.

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“…oder mikrobiologische Hypothese), ohne dass die Frage abschließend geklärt ist [95,96]. Entscheidend für die akuten, jedoch ebenso für die chronischen Veränderungen ist der mechanische Aspekt [97].…”

Section: Osteochondrale Läsionenunclassified

“…Entscheidend für die akuten, jedoch ebenso für die chronischen Veränderungen ist der mechanische Aspekt [97]. Andere Faktoren spielen wahrscheinlich eine Rolle (vaskuläre Hypothese), während weitere Faktoren (mikrobiologische Hypothese, genetische Faktoren) nie bewiesen worden sind [95]. Pathogenetisch ist der Prozess nicht geklärt.…”

Section: Osteochondrale Läsionenunclassified

Differenzialdiagnostik manualmedizinischer Syndrome der unteren Extremität unter Einbeziehung osteopathischer Verfahren

Buchmann

Arens²,

Harke³

et al. 2013

Phys Rehab Kur Med

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Die differenzialdiagnostische Beurteilung schmerzhafter funktioneller Störungen der unteren Extremität ist in der Praxis ein häufiges Problem. Die manualmedizinische Diagnostik kann hier einen wertvollen Beitrag in der Abgrenzung von struktureller und funktioneller Pathologie leisten. Manualmedizinische therapeutische Maßnahmen scheinen für akute und perakute Beschwerden effektiv zu sein. Die Manipulation und Mobilisation myofaszialer Störungen ist entweder Therapie der 1. Wahl oder wird begleitend bei primär orthopädischer oder internistischer Erkrankung eingesetzt. Im folgenden Beitrag werden manualmedizinische Syndrome vorgestellt, die Befundhäufungen aus dem muskuloskeletalem System zusammenfassen. Das erleichtert nicht nur die primäre differenzialdiagnostische Beurteilung, sondern ebenfalls die Therapieplanung. Die Kombination mit den osteopathischen Verfahren ist dabei sehr gewinnbringend. Eine notwendige fachärztliche Differenzialdiagnostik bleibt unumgänglich. Abstract !The differential diagnostic evaluation of painful functional disorders of the lower extremities is in practice very often. The manual medical diagnosis can make here a valuable contribution in the determination of structural and functional pathology. Manual medical therapies seems to be effective for acute and peracute complaints. The mobilization and manipulation (thrust technique) of myofascial restrictions are either the first choice therapy or were alternatively be used concomitantly in orthopedic or internal disorders. In the following review manual medical syndromes are presented that summarize the findings from the musculoskeletal system. This alleviated the primary differential diagnostic evaluation, as well as treatment planning. The combination with osteopathic methods is very profitable. A necessary specialist differential diagnosis remains essential.

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Ätiopathogenetische Aspekte der medialen Osteochondrosis dissecans tali

Cited by 26 publications

References 0 publications

Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Effect of medial opening wedge high tibial osteotomy on intraarticular knee and ankle contact pressures

Treatment principles for osteochondral lesions in foot and ankle

Differenzialdiagnostik manualmedizinischer Syndrome der unteren Extremität unter Einbeziehung osteopathischer Verfahren

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