Medial Malleolar Osteotomy and Osteochondral Autograft Transfer for Osteochondritis Dissecans of the Distal Tibial Plafond

Abstract

Therapeutic, Level IV: Case report.

Effect of Ankle Position and Noninvasive Distraction on Arthroscopic Accessibility of the Distal Tibial Plafond

“…26 Although not widely used during arthroscopic treatment of OLTPs, other studies have shown that additional accessibility can be achieved with the use of arthrotomies and malleolar osteotomies. 19,33 Although our data suggest that ankle distraction is necessary for adequate arthroscopic accessibility of the distal tibial plafond, distraction is not without complications. Ankle distraction significantly increases capsular tension and reduces the safe zone between the anterior distal tibial plafond and anterior neurovascular structures during arthroscopy.…”

“…26 Although not widely used during arthroscopic treatment of OLTPs, other studies have shown that additional accessibility can be achieved with the use of arthrotomies and malleolar osteotomies. 19,33…”

Open tibial pilon fracture with an extensive osteochondral defect: Staged reconstruction

“…The donor areas of autologous osteochondral bone graft are restricted; therefore, for major defects, the allograft represents an option for the tibiotarsal joint with large osteochondral lesions of the talus (10) . Few articles describe this technique for tibial defects (11) .…”

Osteochondral autograft transfer for post-traumatic osteochondral defects of the anterolateral surface of the distal tibial plafond

“…Most osteochondral defects of the tibial plafond are post-traumatic [5] , [6] , [7] , [9] , [11] , [13] , [18] . Such a post-traumatic lesion is an antecedent factor for the development of degenerative changes in several reports [3] , [13] , [16] , [17] .…”

“…OAT in the knee joint is well established and has good results for the treatment of osteochondral defects, and the results of treatment of talar dome lesions have suggested that OAT has good long-term clinical outcomes [8] . However, only a few cases of using OAT for osteochondral defects of the tibial plafond have been reported in the literature [18] . This case report provides an important clinical insight.…”