Osteochondral Lesions of the Talus

Chew, Kelvin T L; Tay, Eileen; Wong, Yue Shuen

doi:10.47102/annals-acadmedsg.v37n1p63

Cited by 41 publications

(6 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diameter of the lesions usually did not exceed 1.5 cm. A total of 18 studies, including 388 patients, described the results of BMS [2, 3, 5, 8, 11, 13, 14, 17–19, 21, 34, 36, 37, 48, 52, 55, 60]. In 329 of 386 patients, treatment was reported to be successful (85%).…”

Section: Resultsmentioning

confidence: 99%

Treatment of osteochondral lesions of the talus: a systematic review

Zengerink

Struijs

Tol³

et al. 2009

Knee Surg Sports Traumatol Arthrosc

547

493

View full text Add to dashboard Cite

The aim of this study was to summarize all eligible studies to compare the effectiveness of treatment strategies for osteochondral defects (OCD) of the talus. Electronic databases from January 1966 to December 2006 were systematically screened. The proportion of the patient population treated successfully was noted, and percentages were calculated. For each treatment strategy, study size weighted success rates were calculated. Fifty-two studies described the results of 65 treatment groups of treatment strategies for OCD of the talus. One randomized clinical trial was identified. Seven studies described the results of non-operative treatment, 4 of excision, 13 of excision and curettage, 18 of excision, curettage and bone marrow stimulation (BMS), 4 of an autogenous bone graft, 2 of transmalleolar drilling (TMD), 9 of osteochondral transplantation (OATS), 4 of autologous chondrocyte implantation (ACI), 3 of retrograde drilling and 1 of fixation. OATS, BMS and ACI scored success rates of 87, 85 and 76%, respectively. Retrograde drilling and fixation scored 88 and 89%, respectively. Together with the newer techniques OATS and ACI, BMS was identified as an effective treatment strategy for OCD of the talus. Because of the relatively high cost of ACI and the knee morbidity seen in OATS, we conclude that BMS is the treatment of choice for primary osteochondral talar lesions. However, due to great diversity in the articles and variability in treatment results, no definitive conclusions can be drawn. Further sufficiently powered, randomized clinical trials with uniform methodology and validated outcome measures should be initiated to compare the outcome of surgical strategies for OCD of the talus.

show abstract

Section: Resultsmentioning

confidence: 99%

Treatment of osteochondral lesions of the talus: a systematic review

Zengerink

Struijs

Tol³

et al. 2009

Knee Surg Sports Traumatol Arthrosc

547

493

View full text Add to dashboard Cite

show abstract

“…Although recent studies confirmed a roughly 45% success rate for non-operative management, there is still controversy whether this approach leads to arthritis or not. 15 Surgical treatment of OLTs can be performed either through open or arthroscopic techniques. The aim is to stimulate the healing process of the defected cartilage, which can be achieved either by micro fracturing or grafting hyaline cartilage.…”

Section: Discussionmentioning

confidence: 99%

“…Ogilvie-Harris scoring system, which consists of swelling, stiffness, pain measurement, and activity, was used. The results were ranked as excellent (15-16 points), good, 15,16 or poor (< 13).…”

Section: Follow-up Evaluationsmentioning

confidence: 99%

Factors predicting the outcome of arthroscopic debridement and microfracture technique in treatment of osteochondral lesions of talus

Torkaman,

Nazari,

Elahifar

et al. 2024

Current Orthopaedic Practice

View full text Add to dashboard Cite

Aims and Scope: Osteochondral lesions of the talus (OLT) are common injuries that occur following ankle sprains and fractures. Surgical management, either through open or arthroscopic technique, is required to eliminate the pain and restore the ankle’s function. This study aims to evaluate the prognostic significance of demographic variables and lesion’s characteristics. Method and Techniques: In this study, 40 ankle (40 patients), who underwent arthroscopic debridement and microfracture technique to treat osteochondral lesion of the talus, were evaluated retrospectively after two years. The functional outcome of the ankle joint was assessed by using foot – ankle disability score, (FADS), pain analysing scale score (PASS), American orthopaedic foot and ankle society (AOFAS) score, and Ogilvie-Harris scaling system. Then the association between patients’ age and gender, and the lesions’ characteristics, including size, grade, and location, were evaluated. Results: Outcome results varied according to the scoring system, but all patients achieved satisfied outcome and pain relieve. Younger patients with smaller lesions achieved a better clinical result. All measures including PASS, AOFAS, Ogilvie-Harris, FADS appeared to be significantly better in smaller lesions. (P-value <0.05) PASS and Ogilvie-Harris scales showed better results in younger patients. Ogilvie-Harris test result was notably superior in the lateral lesions. Conclusion: The patient’s age and size of the lesion are two prognostic factors of arthroscopic debridement and microfracture of OLTs. We believe arthroscopic management can be associated with a better outcome in lesions smaller than 1.5 cm in diameter and patients younger than 40-years-old. Level of Clinical Evidence: Level 2 – prognostic study

show abstract

“…Arthroscopically assisted approaches have been used by many authors for the treatment for cartilage defects of the talar dome [3, 7, 17, 18, 20]. The main difficulty reported with this technique concerns the accessibility of the posteromedial and central regions of the talar articular surface, often requiring an additional osteotomy of the medial malleolus [6, 26] or a transmalleolar approach [19, 27, 31].…”

Section: Introductionmentioning

confidence: 99%

An anterior ankle arthroscopic technique for retrograde osteochondral autograft transplantation of posteromedial and central talar dome cartilage defects

Wajsfisz

Makridis²,

Naji

et al. 2013

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

This cadaveric study showed that the retrograde osteochondral autograft transplantation technique in the talus is feasible. It can be used to restore the posteromedial and central talar articular surfaces using conventional ankle arthroscopic instrumentation and anterior arthroscopic portals without resorting to a medial malleolar osteotomy. Further clinical and biomechanical studies are required to prove the efficacy of this technique and its reproducibility in routine clinical practice.

show abstract

Osteochondral Lesions of the Talus

Cited by 41 publications

References 53 publications

Treatment of osteochondral lesions of the talus: a systematic review

Treatment of osteochondral lesions of the talus: a systematic review

Factors predicting the outcome of arthroscopic debridement and microfracture technique in treatment of osteochondral lesions of talus

An anterior ankle arthroscopic technique for retrograde osteochondral autograft transplantation of posteromedial and central talar dome cartilage defects

Contact Info

Product

Resources

About