Osteochondral lesion of the talus: What are we talking about?

Barbier, Olivier; Amouyel, Thomas; l’Escalopier, Nicolas de; Cordier, Guillaume; Baudrier, Nicolas; Benoist, Jonathan; Dubois-Ferrière, Victor; Leiber, Frédéric; Morvan, Antoine; Mainard, Didier; Maynou, C.; Padiolleau, Giovany; Lopes, Ronny

doi:10.1016/j.otsr.2021.103068

Cited by 19 publications

(8 citation statements)

References 15 publications

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“…In nearly 80% of patients with OLT a history of ankle trauma can be found ( 3 , 4 ). Thirty-eight percent of patients with OLT present ankle ligament laxity and 39% of patients with ankle instability present with an OLT ( 5 , 6 ). Subsequently, acute trauma and repetitive micro-traumata due to ankle instability and/or hindfoot malalignment seem to be a leading cause of OLT.…”

Section: Aetiologymentioning

confidence: 99%

Section: Symptoms and Diagnosticmentioning

confidence: 99%

“…The centromedial zone is the most commonly involved (31–42%) ( 4 , 5 ). Medial lesions tend to be bigger and deeper, lateral lesions tend to be smaller but more often associated with a ligament laxity ( 5 ). No correlation has been found between location of the OLT and extent of preoperative pain, functional scores and stage of injury ( 5 ).…”

Section: Symptoms and Diagnosticmentioning

confidence: 99%

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Osteochondral lesion of the talus: still a problem?

Krause

Anwander

2022

EFORT Open Reviews

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Osteochondral lesion of the talus (OLT) often occurs after ankle trauma or repetitive micro-traumata, whereas the actual etiology remains unclear. The most common symptoms are local pain deep in the medial or lateral ankle that increases with weight-bearing and activity, accompanied by tenderness and swelling. Eventually, most patients with symptomatic or unstable OLT require surgery. Many reasonable operative techniques have been described, whereas most lead to similar and satisfactory results. They can be divided into cartilage repair, cartilage regeneration and cartilage replacement techniques. The OLT size and morphology in the first place but also surgeon and individual patient aspects are considered when it comes to surgery. For high postoperative success and low recurrence rates, underlying causes, for example, ligamentous instability and hindfoot malalignment should also be addressed during surgery.

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Section: Aetiologymentioning

confidence: 99%

Section: Symptoms and Diagnosticmentioning

confidence: 99%

Section: Symptoms and Diagnosticmentioning

confidence: 99%

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Osteochondral lesion of the talus: still a problem?

Krause

Anwander

2022

EFORT Open Reviews

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“…This may be related to its anatomical-physiological characteristics (absence of muscle insertion, poor vascularisation) and its anatomical position at the crossroads of the mechanical constraints of the talus and tibia (Dufour (2015)). Just as it is more sensitive to osteochondral lesions in sportsmen and women (Barbier et al (2021)), it seems to be more sensitive to deformation in CP individuals with equinus gait. This suggests that the evolution of the shape of the talus should be monitored more closely.…”

Section: Subject-level Analysismentioning

confidence: 99%

Comprehensive personalized ankle joint shape analysis of children with cerebral palsy from pediatric MRI

Cheng

Bailly²,

Scavinner-Dorval³

et al. 2022

Front. Bioeng. Biotechnol.

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Cerebral palsy, a common physical disability in childhood, often causes abnormal patterns of movement and posture. To better understand the pathology and improve rehabilitation of patients, a comprehensive bone shape analysis approach is proposed in this article. First, a group analysis is performed on a clinical MRI dataset using two state-of-the-art shape analysis methods: ShapeWorks and a voxel-based method relying on Advanced Normalization Tools (ANTs) registration. Second, an analysis of three bones of the ankle is done to provide a complete view of the ankle joint. Third, a bone shape analysis is carried out at subject level to highlight variability patterns for personnalized understanding of deformities.

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“…Osteochondral lesions of the talus (OLT) are challenging to manage for the orthopedic surgeon, due to the poor self‐healing capacity of the cartilage tissue and the difficulty to restore its biomechanical features. These lesions, often affecting a young population and causing pain and functional impairment, when untreated can be characterized by a progressive degeneration into ankle osteoarthritis with a reported frequency ranging from 17 to 50%, [1–4]. OLTs may be consequent to acute ankle trauma, usually occur 6 to 12 months after the initial trauma, or a consequence of chronic ankle instability, with an incidence reported in 16 to 54% of cases of ankle instabilities [5–8].…”

Section: Introductionmentioning

confidence: 99%

Hyaluronic scaffold transplantation with bone marrow concentrate for the treatment of osteochondral lesions of the talus: durable results up to a minimum of 10 years

Vannini,

Berveglieri,

Boffa

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose The aim of this study was to evaluate the long‐term clinical results of the transplantation of a hyaluronic acid membrane augmented with bone marrow aspirate concentrate (BMAC) in an one‐step technique for the treatment of patients affected by osteochondral lesions of the talus (OLT). Methods A total of 101 patients (64 men, 37 women, age 32.9 ± 10.9) were evaluated for a minimum of 10 years of follow‐up (151.5 ± 18.4 months) The mean lesion size was 2.2 ± 1.4 cm2, the lesion had a post‐traumatic origin in 73 patients, 15 patients previously had an ankle fracture, 22 patients had ankle osteoarthritis. All patients were clinically evaluated at baseline and at 2, 5, and a minimum of 10 years after treatment using the AOFAS score, the NRS for pain, and the Tegner score. A survival analysis was performed to check the survival to failure up to the last follow‐up. Results The AOFAS score significantly improved from baseline (59.6 ± 13.9) to the final follow‐up (82.3 ± 14.2) (p < 0.0005). A significant reduction in the AOFAS score was found from 2 to 10 years (p < 0.0005). The NRS for pain changed from 7.0 ± 1.3 at baseline to 3.9 ± 2.7 at the final follow‐up (p < 0.0005). A significant worsening was documented between 5 years and the final follow‐up (p < 0.0005). The Tegner score improved from the preoperative value of 2.0 (range 1–7) to 3.0 (range 1–7) at the final follow‐up (p < 0.0005), although it remained lower as compared to the preinjury level of 4.0 (range 1–9) (p < 0.0005). Better results were documented in male and younger patients with smaller lesions, without the previous surgery, and without the previous ankle fractures or osteoarthritis. At the final follow‐up, 85 patients considered their general health status “satisfactory” and 84 patients reported feeling “better” than the preoperative condition. Five patients were considered failures and underwent prosthetic ankle replacement or repeated the same surgery. Conclusion This one‐step technique showed to be an effective procedure for the treatment of OLT, providing a low failure rate and offering durable clinical improvements up to a minimum of 10 years of follow‐up. However, this technique demonstrated a small yet significant decrease over the years in terms of pain and function and poor results in terms of sports activity level. Level of evidence Level IV.

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Osteochondral lesion of the talus: What are we talking about?

Cited by 19 publications

References 15 publications

Osteochondral lesion of the talus: still a problem?

Osteochondral lesion of the talus: still a problem?

Comprehensive personalized ankle joint shape analysis of children with cerebral palsy from pediatric MRI

Hyaluronic scaffold transplantation with bone marrow concentrate for the treatment of osteochondral lesions of the talus: durable results up to a minimum of 10 years

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