Characteristics of Osteochondral Lesions of the Talus in Different Age Groups

Cao, Yongxing; Xu, Yang; Huang, Qiang; Yuan, Hong; Xu, Xiangyang

doi:10.1055/a-1186-1575

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…The efficacy of cerebellar tDCS in patients of different ages was also assessed using subgroup analysis. According to previous studies on stroke, someone aged less than 40 years was defined as a young adult, 40–60 years as middle-aged, and over 60 years as old-aged ( 19 , 20 ). Due to the small number of young-adult patients in this study ( n = 4), young-adult patients and middle-aged patients were combined into young-/middle-aged patients.…”

Section: Resultsmentioning

confidence: 99%

Effects of cerebellar transcranial direct current stimulation on rehabilitation of upper limb motor function after stroke

et al. 2023

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BackgroundThe cerebellum is involved in the control and coordination of movements but it remains unclear whether stimulation of the cerebellum could improve the recovery of upper limb motor function. Therefore, this study aimed to explore whether cerebellar transcranial direct current stimulation (tDCS) therapy could promote the recovery of upper limb motor function in patients who suffered a stroke.MethodsIn this randomized, double-blind, and sham-controlled prospective study, 77 stroke patients were recruited and randomly assigned to the tDCS group (n = 39) or the control group (n = 38). The patients received anodal (2 mA, 20 min) or sham tDCS therapy for 4 weeks. The primary outcome was the change in the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score from baseline to the first day after 4 weeks of treatment (T1) and 60 days after 4 weeks of treatment (T2). The secondary outcomes were the FMA-UE response rates assessed at T1 and T2. Adverse events (AEs) related to the tDCS treatment were also recorded.ResultsAt T1, the mean FMA-UE score increased by 10.7 points [standard error of the mean (SEM) = 1.4] in the tDCS group and by 5.8 points (SEM = 1.3) in the control group (difference between the two groups was 4.9 points, P = 0.013). At T2, the mean FMA-UE score increased by 18.9 points (SEM = 2.1) in the tDCS group and by 12.7 points (SEM = 2.1) in the control group (the difference between the two groups was 6.2 points, P = 0.043). At T1, 26 (70.3%) patients in the tDCS group had a clinically meaningful response to the FMA-UE score compared to 12 (34.3%) patients in the control group (the difference between the two groups was 36.0%, P =0.002). At T2, 33 (89.2%) patients in the tDCS group had a clinically meaningful response to the FMA-UE score compared with 19 (54.3%) patients in the control group (the difference between the two groups was 34.9%, P = 0.001). There was no statistically significant difference in the incidence of adverse events between the two groups. In the subgroup analysis of different hemiplegic sides, the rehabilitation effect of patients with right hemiplegia was better than that of patients with left hemiplegia (P < 0.05); in the age subgroup analysis, different age groups of patients did not show a significant difference in the rehabilitation effect (P > 0.05).ConclusionCerebellar tDCS can be used as an effective and safe treatment to promote recovery of upper limb motor function in stroke patients.Trial registrationChiCTR.org.cn, identifier: ChiCTR2200061838.

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Section: Resultsmentioning

confidence: 99%

Effects of cerebellar transcranial direct current stimulation on rehabilitation of upper limb motor function after stroke

et al. 2023

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“…Elias et al found that injuries located in the medial third were larger and deeper than those located elsewhere [ 3 ]. Cao et al noted that deeper-position cystic changes in the medial subchondral talus were typical of patients over 60 years of age with talar cartilage injuries [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

SPECT/CT imaging features of cystic degeneration of the talus and their relation to pathological findings

et al. 2022

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Background Osteochondral lesions of the talus (OLTs) are a common orthopedic condition. The image presentation is very similar to that of ischemic necrosis of the talus complicated by a talar neck fracture, but the two are very different lesions. When abnormalities in bone density (or signal) of the talar body (apex of the fornix) with concomitant bone defects and cystic changes are found on X-ray, computed tomography (CT), or magnetic resonance imaging, it is important to accurately determine the nature of the lesion and make a correct diagnosis for the treatment and prognosis of the patient. The purpose of this study was to explore the imaging features of three-phase single-photon emission computed tomography (SPECT)/CT images of cystic lesions of the talus. Methods A total of 189 patients with chronic pain in the ankle joint suspected to be caused by cystic degeneration of the talus were enrolled. All patients underwent 99mTc-methyl diphosphonate (99mTc-MDP) three-phase SPECT/CT bone imaging and delayed scans in our hospital. The location, range of involvement, classification, CT value, and radioactivity uptake of the sclerotic areas of cystic lesions on the talus, and the continuity of the articular surface, were recorded. All recorded parameters were analyzed in comparison with pathological results. Results Eighty-three percent (157/189) of the talar cysts were located on the medial fornix, largely involving the anterior middle part (43.27%), with larger cysts involving the posterior part (9.6%). Sixty-three percent (119/189) of the patients had type I lesions and 37% (70/189) had type II lesions. The articular surface of the medial dome of the talus was intact in all patients, but the subchondral bony articular surface was rough in 88% (166/189) of patients. The coincidence rate for the location, type, and range of involvement of cystic lesions with the pathological results was 87.83% (166/189). The mean CT value of the cystic lesions was 45 ± 15 HU (30–60 HU). The percentages of pathological chondrogenesis in high CT value ≥ 50 HU (19/70) and low CT value < 50 HU (51/70) groups were 89.47% (17/19) and 29.14% (15/51) (χ2 = 20.12, p < 0.001), respectively. The target/background ratio (T/B ratio) of the radioactivity-uptake area of the talus vault was 2.0 ± 0.5 (1.5–2.5). The percentages of pathological new trabecular bone in those with a T/B ratio ≥ 2.0 (157/189) and T/B ratio < 2.0 (32/189) were 82.80% (130/157) and 25.00% (8/32; χ2 = 45.08, p < 0.001), respectively. Conclusions Three-phase bone imaging could identify damage of the talus caused by cystic degeneration, while delayed SPECT/CT images showed advantages for displaying bone microstructure, blood supplement, and bone metabolism when examining the location, range of involvement, classification, and repair of cystic lesions of the talus.

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“…Elias et al found that the injury located in the medial 1/3 was larger and deeper [3]. Cao et al noted that deeper position cystic changes in the medial subchondral talus were typical of patients with talar cartilage injuries over 60 years of age [23].…”

Section: Discussionmentioning

confidence: 99%

Study on SPECT/CT Imaging Features and Related Pathology of Cystic Generation of the Talus

Song

Zeng

Huang

et al. 2022

Preprint

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Objective: To explore the imaging features of three-phase bone and SPECT/CT images of cystic lesions on the talus. Methods: A total of 189 patients with suspected chronic pain in the ankle joint of the talus cystic degeneration were enrolled in this retrospective study, who underwent 99mTc-MDP three-phase bone imaging and delayed SPECT/CT scans in our hospital. The location, range of involvement, classification, CT value, and radioactivity uptake of the sclerosis of cystic lesions on the talus, and the continuity of articular surface were observed. Comparisons were analyzed with the pathological results. Results: Totally, 83% (157/189) of the talar cysts were located to the medial fornix, most of which involved the anterior middle part (43.27%), and the larger cysts involved the posterior part (9.6%). 63% (119/189) of the patients were type I, and 37% (70/189) of the patients were type II. The articular surface of the medial dome of the talus of all of the patients was intact, and the subchondral bony articular surface of 88% (166/189) patients was rough. The coincidence rate of the location, type, range of involvement of cystic lesions with pathological results was 87.83% (166/189). The CT value of cystic lesions was 45 15Hu (30-60Hu). The percentage of pathological chondrogenesis in the high CT value ≥ 50Hu (19/70) group and the low CT value < 50Hu (51/70) group were 89.47% (17/19) and 29.14% (15/51) (c2=20.12, P＜0.001), respectively. The T/B ratio of the radioactivity uptake area of the talus vault was 2.0±0.5(1.5-2.5). The percentage of pathological new trabecular bones in T/B ratio≥2.0 (157/189) group and T/B ratio＜2.0 (32/189) group (c2=45.08，P＜0.001) were 82.80% (130/157) and 25.00% (8/32), respectively. Conclusions: Three-phase bone imaging could identify the damage of the talus caused by cystic degeneration, and delayed SPECT/CT images have certain advantages in display the location, range of involvement, classification, and repair of cystic lesions of the talus.

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Characteristics of Osteochondral Lesions of the Talus in Different Age Groups

Cited by 6 publications

References 33 publications

Effects of cerebellar transcranial direct current stimulation on rehabilitation of upper limb motor function after stroke

Effects of cerebellar transcranial direct current stimulation on rehabilitation of upper limb motor function after stroke

SPECT/CT imaging features of cystic degeneration of the talus and their relation to pathological findings

Study on SPECT/CT Imaging Features and Related Pathology of Cystic Generation of the Talus

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