Navigierte retrograde Anbohrung bei Osteochondrosis dissecans (OCD) des Talus

Richter, Martinus; Zech, Stefan

doi:10.1007/s00064-010-9005-x

Cited by 9 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, navigated retrograde drilling has been introduced by Richter et al who used navigated retrograde drilling to treat 52 patients with OLT. 48 patients were available to analyze at the post-operative visit with improvement of functional outcomes (mean SF-36 of 96 points (range, 86-100 points) and mean VAS score of 93 points (range, 86-100 points) at the final post-operative visit) [ 96 ].…”

Section: Surgical Strategiesmentioning

confidence: 99%

Management of Osteochondral Lesions of the Talar Dome

Rungprai¹,

Tennant²,

Gentry³

et al. 2017

TOORTHJ

View full text Add to dashboard Cite

Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. While the natural history of the OLTs is not well understood, surgical treatment is often required especially in chronic cases and acute cases with displaced articular fragments. Arthroscopic treatment of the OLTs aims to restore ankle joint function and pain relief by the removal of the chondral or osteochondral fragment, debridement and stabilization of cartilage rim and subchondral bone, and stimulate healing of the bone and damaged cartilage. In patients with a large lesion or after a failure of previous bone marrow stimulation, biologic restoration techniques including the use of particulate juvenile cartilage techniques, autogenous chondrocyte implantation, and osteochondral autograft or allograft transplantation may have role. This article summarizes the contemporary concepts in the clinical evaluation and treatment of OLTs with particular emphasis on surgical strategies.

show abstract

Section: Surgical Strategiesmentioning

confidence: 99%

Management of Osteochondral Lesions of the Talar Dome

Rungprai¹,

Tennant²,

Gentry³

et al. 2017

TOORTHJ

View full text Add to dashboard Cite

show abstract

“…Navigation systems offer higher precision compared with uoroscopy-guided techniques; thus, different navigation techniques have been established, such as opto-electronic guidance systems, 3-dimensional uoroscopy-based, MRI-based, or computed tomography-based methods [26]. Good results have been published with computer-assisted minimally invasive retrograde drilling [11]. Nevertheless, navigated procedures are time-consuming operations as the setup, image acquisition, registration and veri cation must be obtained [27].…”

Section: Discussionmentioning

confidence: 99%

“…In stable OCD, non-surgical treatment includes abstinence of certain sports and compression loads as well as adjustment of vitamin D levels [7,8]. An e cient and commonly employed surgical therapy of nearly unstable OCD is arthroscopically-assisted drilling for subchondral decompression and revascularization [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Electromagnetic Navigation Reduces Radiation Exposure and Provides Excellent Accuracy for Retrograde Drilling in Osteochondrosis Dissecans of the Talus

Berger-Groch

Jungesblut

Hoffmann

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Retrograde drilling in osteochondrosis dissecans (OCD) is a widely used surgical intervention. A radiation-free electromagnetic navigation system (ENS)-based method was compared with the standard freehand fluoroscopic (SFF) method regarding clinical applicability.Methods: We performed a clinical cohort study at a department of Orthopaedics in a Level 1 children’s hospital with 40 patients (20 SFF and 20 ENS). Retrograde drilling of the talar dome was used in patients with unstable medial OCD (MRI stage 2 according to Hepple’s revised classification; stage 2 according to the International Cartilage Repair Society). The outcome measurements were: a) Intraoperative fluoroscopy exposure and length of surgery and b) Postoperative serial follow-up MRIs every 6 months.Results: 22 female and 18 male patients aged 13.8 ± 1.6 years (range: 11-17 years) were included. Using the ENS technique, length of surgery was significantly reduced to 20.2 ± 6.4 min compared to 36.1 ± 11.8 min (p<0.01) for the SFF technique. The average x-ray radiation time for the SFF technique was 23.5 ± 13.5 sec and 1.9 ± 1.7 sec for the ENS technique (p<0.01). Radiation exposure was significantly reduced from 44.6 ± 19.7 mSv (SFF technique) to 5.6± 2.8 mSv (ENS technique) (p<0.01). Intraoperative perforation of cartilage occurred once in the SFF group. Correct placement of the drilling channel was verified in all patients on follow-up MRI after six months and a timely healing was seen after two years. No differences were detected on follow-up MRI between the two methods.Conclusions: The ENS method provides for a significant reduction in length of surgery and radiation exposure. ENS was without intraoperative cartilage perforation. The clinical and radiological follow-up parameters are comparable for SFF- and ENS-guided retrograde drilling.Trial registration: WF – 085/20, 05/2020 “retrospectively registered”

show abstract

“…A diagnostic arthroscopy can be performed prior to the procedure to classify the lesion. 28 With mobile 3D-fluoroscopy navigation, immediate verification of the result of surgery is feasible and recommended. The dynamic reference is placed in the talar neck without interfering with the scanning field or the instruments.…”

Section: Minimally Invasive Treatment Of Acetabular Fracturesmentioning

confidence: 99%