Location Distribution of 2,087 Osteochondral Lesions of the Talus

Diepen, Pascal R. van; Dahmen, Jari; Altink, J. Nienke; Stufkens, Sjoerd A.S.; Kerkhoffs, Gino M. M. J.

doi:10.1177/1947603520954510

Cited by 43 publications

(26 citation statements)

References 83 publications

(114 reference statements)

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“…The 9-grid scheme by Elias et al 28 and Raikin et al 19 was used and the study concluded that the majority of the lesions were located on the anterior talar dome with a higher incidence rate on the anterolateral talar dome. This finding is in contrast to the findings of a recently performed meta-analysis by van Diepen et al 7 who found that 59% of the osteochondral lesions of the talus were located on the posterior side of the talar dome with the most commonly reported anatomical location being the centromedial zone (31%). As the publication by van Diepen et al 7 consisted of mostly chronic osteochondral lesions and because of the fact that there is evidence that (antero)lateral lesions are potentially predominantly caused by traumatic events, it can be stated that the finding of the anteriorly located (O)CLs in the isolated syndesmotic injury group follows the specific evidence currently available on location distribution.…”

Section: Discussioncontrasting

confidence: 99%

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Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic Injuries: A Systematic Review and Meta-Analysis

et al. 2022

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Objective To determine and compare the incidence rate of (osteo)chondral lesions of the ankle in patients with acute and chronic isolated syndesmotic injuries. Design A literature search was conducted in the PubMed (MEDLINE) and EMBASE (Ovid) databases from 2000 to September 2021. Two authors independently screened the search results, and risk of bias was assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria. Studies on acute and chronic isolated syndesmotic injuries with pre-operative or intra-operative imaging were included. The primary outcome was the incidence rate with corresponding 95% confidence intervals (CIs) of (osteo)chondral lesions of the ankle in combined and separate groups of acute and chronic syndesmotic injuries. Secondary outcomes were anatomic distribution and mean size of the (osteo)chondral lesions. Results Nine articles (402 syndesmotic injuries) were included in the final analysis. Overall (osteo)chondral lesion incidence was 20.7% (95% CI: 13.7%-29.9%). This rate was 22.0% (95% CI: 17.1-27.7) and 24.1% (95% CI: 15.6-35.2) for acute and chronic syndesmotic injuries, respectively. In the combined acute and chronic syndesmotic injury group, 95.4% of the lesions were located on the talar dome and 4.5% of the lesions were located on the distal tibia. (Osteo)chondral lesion size was not reported in any of the studies. Conclusions This meta-analysis shows that (osteo)chondral lesions of the ankle are present in 21% of the patients with isolated syndesmotic injuries. No difference in incidence rate was found between the different syndesmotic injury types and it can be concluded that the majority of lesions are located on the talar dome. PROSPERO Registration Number: CRD42020176641

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Section: Discussioncontrasting

confidence: 99%

“…Our secondary hypothesis is that lesion size is heterogeneous and that most lesions are located in the anterolateral talar dome which is known to be a more common location for post-traumatic (O)CLs of the ankle. 7 …”

Section: Introductionmentioning

confidence: 99%

Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic Injuries: A Systematic Review and Meta-Analysis

et al. 2022

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“…Arthroscopic joint debridement and microfracture are indicated for the management of limited (no more than 15 mm in diameter and 8 mm in depth) OLTs [ 21 , 22 ]. OLTs are commonly encountered in CLAI patients undergoing surgery and are mostly located over the centromedial portion and the anterolateral portion of the talus [ 23 , 24 ]. It is more likely that OLTs of the medial portion of the talus are present in patients with long-standing CLAI [ 25 ] and rotational instability of the ankle [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Limited medial osteochondral lesions of the talus associated with chronic ankle instability do not impact the results of endoscopic modified Broström ligament repair

Feng

Chen

et al. 2022

J Orthop Surg Res

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Background The arthroscopic modified Broström procedure, with repair of the anterior talofibular ligament and extensor retinaculum, produces good functional outcomes in patients with chronic lateral ankle instability (CLAI). CLAI can be associated with osteochondral lesions of the talus (OLTs). It remains unclear whether associated limited OLTs affect clinical outcomes in such patients. Methods This retrospective cohort study included 92 CLAI patients with and without OLTs undergoing an all-inside arthroscopic modified Broström procedure from June 2016 to May 2019. The patients were divided into non-lesion group (n = 32) and lesion group (n = 60) according to whether CLAI was associated or not with OLTs. All the osteochondral lesions less than 15 mm in diameter were managed with bone marrow stimulation techniques (arthroscopic microfracture) at the time of the arthroscopic modified Broström procedure. The Visual Analogue Scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, Karlsson Ankle Function Score (KAFS), Anterior Talar Translation (ATT), Active Joint Position Sense (AJPS), and the rate of return to sports were compared in both groups. Results Increase in all the functional scores (VAS, AOFAS, KAFS, ATT, and AJPS) in both groups was, respectively, recorded 1 year and 2 years after surgery. At the 1-year and 2-year follow-up, there was no significant difference in the VAS, AOFAS, KAFS, ATT, and AJPS scores between the non-lesion and lesion groups. Conclusion In patients with CLAI who underwent an arthroscopic modified Broström procedure, the presence of limited OLTs (less than 15 mm in diameter), which required arthroscopic microfracture, did not exert any influence on outcome. Level of Evidence Level III, a retrospective comparative study.

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“…On the basis of the normal model, the talus cartilage was divided into 9 regions by the nine-grid partition method. Studies have shown that area 4 is the most common area for talus cartilage injuries [13,14]. In this study, defects in the cartilage and subchondral bone in region 4 of the talus were simulated.…”

Section: Construction Of the Working Condition Modelmentioning

confidence: 99%

The Effect of Talus Osteochondral Defects of Different Area Size on Ankle Joint Stability: A Finite Element Analysis

Li¹,

Wang²,

Wei³

et al. 2021

Preprint

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(1) Background: Osteochondral lesion of the talus (OLT) is one of the common ankle injuries, which will lead to biomechanical changes in the ankle joint and ultimately affect the ankle function. The finite element analysis (FEA) was used to clarify the effect of talus osteochondral defects in different depths on the stability of the ankle joint. However, there is no clear research about the area of talus osteochondral defects that should be intervened in time. In this research, FEA is used to simulate the effect of different areas size of talus osteochondral defect on the stress and stability of ankle joint under a certain depth defect.; (2) Methods: The different area size (Normal, 2 mm* 2 mm, 4 mm* 4 mm, 6 mm* 6 mm, 8 mm* 8 mm, 10 mm* 10 mm, 12 mm* 12 mm) of osteochondral defects three-dimensional finite element model was established to simulate and calculate joint stress and displacement of the articular surface of the distal tibia and the proximal talus while the ankle joint was in the push-off phase, midstance phase and heel-strike phase; (3) Results: When OLT occurred, the contact pressure of articular surface, the equivalent stress of the proximal talus, tibial cartilage and talus cartilage did not change significantly with the increase of osteochondral defect area size in heel-strike phase below 6 mm * 6 mm, it increased gradually from 6 mm * 6 mm in midstance phase and push-off phase, and reached the maximum when the defect area size is 12 mm * 12 mm. The talus displacement also has the same tendency.; (4) Conclusions: The effect of cartilage area size defects of the talus on the biomechanics of the ankle is obvious especially in the midstance phase and push-off phase. When the defect size reaches 6 mm * 6 mm, the most obvious change in the stability of the ankle joint occurs, and the effect does not increase linearly with the increase in the depth of the defect.

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Location Distribution of 2,087 Osteochondral Lesions of the Talus

Cited by 43 publications

References 83 publications

Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic Injuries: A Systematic Review and Meta-Analysis

Incidence of (Osteo)Chondral Lesions of the Ankle in Isolated Syndesmotic Injuries: A Systematic Review and Meta-Analysis

Limited medial osteochondral lesions of the talus associated with chronic ankle instability do not impact the results of endoscopic modified Broström ligament repair

The Effect of Talus Osteochondral Defects of Different Area Size on Ankle Joint Stability: A Finite Element Analysis

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