Osteochondritis dissecans of the ankle. A 20-year follow-up study

Bauer, Mats; Jonsson, Kjell; Lindén, Bjarne

doi:10.1302/0301-620x.69b1.3818743

Cited by 163 publications

(94 citation statements)

References 13 publications

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“…2,7,12,15,18 The natural history of OLTs is not well described. It is unclear whether these lesions tend to progress in terms of size and symptoms or lead to joint deterioration.…”

Section: Introductionmentioning

confidence: 99%

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Natural History of Nonoperatively Treated Osteochondral Lesions of the Talus

et al. 2014

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BACKGROUND We hypothesized that patients undergoing nonoperative treatment for asymptomatic or minimally symptomatic osteochondral lesions of the talus (OLTs) would not deteriorate clinically or radiologically over time. METHODS Forty-eight patients (mean age = 48 years; range, 13-78 years) with an OLT confirmed by magnetic resonance imaging (MRI) who had not undergone ankle joint surgery were retrospectively reviewed. All patients were evaluated after a minimum follow-up of 2 years (mean = 52 months; range, 27-124 months). All patients filled out an individual questionnaire and underwent a physical and radiographic assessment (radiograph and hindfoot MRI). RESULTS At final follow-up, 43 ankles (86%) in 41 patients were pain-free (visual analogue scale [VAS] 0, n = 12) or less painful (VAS 1-3, n = 31). Radiographically, osteoarthritis was absent in 47%, and grade 1 and 2 osteoarthritis each were found in 27% (van Dijk classification). Magnetic resonance imaging revealed no substantial progression in staging or lesion size. Pain at time of follow-up correlated with the depth of the lesion at initial MRI (P < .05) and with subchondral cyst formation and presence or change of bone marrow edema at follow-up MRI (P < .05). CONCLUSION Minimally symptomatic OLTs did not appear to progress or worsen over time when treated nonoperatively.

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“…2,7,12,15,18 The natural history of OLTs is not well described. It is unclear whether these lesions tend to progress in terms of size and symptoms or lead to joint deterioration.…”

Section: Introductionmentioning

confidence: 99%

“…It is unclear whether these lesions tend to progress in terms of size and symptoms or lead to joint deterioration. [2][3][4]9,12,[17][18][19] The purpose of this study was to describe the natural history of OLTs in a cohort of patients treated nonoperatively.…”

Section: Introductionmentioning

confidence: 99%

Natural History of Nonoperatively Treated Osteochondral Lesions of the Talus

et al. 2014

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“…18 No patients who were diagnosed with OCD of the talus during childhood developed osteoarthritis. 18 Management of juvenile OCD of the talus remains controversial. Earlier studies recommend conservative management, whereas more recent studies advocate surgical management when 6 months of conservative management fails.…”

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confidence: 99%

Conservative Treatment for Juvenile Osteochondritis Dissecans of the Talus

Lam

Siow

2012

J Orthop Surg (Hong Kong)

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purpose. To assess outcome of 6 juvenile patients with osteochondritis dissecans (OCD) of the ankle treated conservatively. Methods. Records of 4 males and one female aged 10.8 to 14.1 (mean, 12.3) years who underwent cast immobilisation and/or restriction of physical activities for OCD of the talus (4 on the left and 2 on the right) were reviewed. OCD lesions were graded using the Berndt and Harty classification. Functional outcome was assessed using the ankle-hindfoot score of the American Orthopaedic Foot and Ankle Society. Clinical and radiographic outcomes were assessed according to the Higuera classification. results. The mean follow-up period was 30.5 (range, 11-63) months. The mean ankle-hindfoot score was 90 (range, 86-100). Radiological resolution of OCD was noted in 2 ankles, although all ankles showed some degree of healing. All patients had resolution of pain after a mean of 7 (range, 3-12) months. Surgery 2012;20(2):176-80 outcome was excellent in one and good in 5 ankles, whereas radiological outcome was excellent in 2, good in 2, and fair in 2 ankles. In one patient, the OCD of the right posteromedial talar dome resolved spontaneously. conclusion. Almost all patients achieved good functional outcome after conservative management, regardless of the presence of radiological evidence of healing. Surgery should only be performed if the OCD is unstable. Journal of Orthopaedic

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] The lesions are classified into four stages: stage I, a small area of compression of subchondral bone; stage II, a partially detached osteochondral fragment; stage III, a completely detached fragment which remains in the talar crater; and stage IV, displacement of the fragment. We have shown that arthroscopic drilling is appropriate for young patients with an early stable lesion.…”

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confidence: 99%

Fixation of osteochondral lesions of the talus using cortical bone pegs

Kumai

Takakura

Kitada

et al. 2002

The Journal of Bone and Joint Surgery

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We have treated osteochondral lesions of the talus using cortical bone pegs. We examined 27 ankles (27 patients) after a mean follow-up of 7.0 years (2 to 18.8). The mean age of the patients was 27.8 years (12 to 62). An unstable osteochondral fragment or osteosclerotic changes in the bed of the talus were regarded as indications for the procedure. The clinical results were good in 24 ankles (89%) and fair in three (11%); none had a poor result. There was also radiological improvement in 24 ankles. Repair of the articular surface and stability of the lesion can be achieved even in unstable chronic lesions.

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Osteochondritis dissecans of the ankle. A 20-year follow-up study

Cited by 163 publications

References 13 publications

Natural History of Nonoperatively Treated Osteochondral Lesions of the Talus

Natural History of Nonoperatively Treated Osteochondral Lesions of the Talus

Conservative Treatment for Juvenile Osteochondritis Dissecans of the Talus

Fixation of osteochondral lesions of the talus using cortical bone pegs

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