Treatment of Osteochondritis Dissecans of the Talus in Skeletally Immature Population

Abstract

Therapeutic, Level IV.

Postsurgical Evaluation of the Pediatric Foot and Ankle

“…OCD is uncommon in preschool children, more frequent in schoolchildren, especially adolescents (13-14 years), and increasingly in girls. 38 Radiographs were classically used to diagnose and characterize OCD, rule out other injuries, and evaluate skeletal maturity. They are also useful to assess loose bodies (a possible pitfall for MRI).…”

“…OCD is uncommon in preschool children, more frequent in schoolchildren, especially adolescents (13–14 years), and increasingly in girls. 38…”

“…When conservative treatment fails, there are loose bodies, or in cases of an unstable lesion, surgery is indicated. 38 The decision to perform one surgical procedure over another depends on whether cartilage, subchondral bone, or both are affected, and also on the location and size of the lesion. Surgical techniques include fixation of the bone or chondral fragments in acute cases, debridement of the lesions, bone marrow stimulation, and retrograde drilling or bone grafting of bone defects if the overlying cartilage is intact.…”

Using Magnetic Resonance Imaging to Identify Complications Associated with Bioabsorbable Implant Fixation of Osteochondral Lesions: A Practical Guide

“…Although epidemiologic evidence that accounts for this broad category of disorders is lacking, OCD has an estimated prevalence of 9.5 to 29 per 100,000 population, with an increased predilection in male adolescents [8]. The lateral aspect of the medial femoral condyle is the classic location for osteochondral lesions, yet they also present frequently in the elbow and ankle and, less commonly, in the shoulder and hip [4, 11, 19]. Given that repetitive microtrauma, at least theoretically, plays a role in the pathogenesis of osteochondral lesions, social patterns of sport specialization and year-round competition may increase the incidence of osteochondral lesions in adolescents [3].…”

A Systematic Review of the Retrograde Drilling Approach for Osteochondral Lesion of the Talus: Questioning Surgical Approaches, Outcome Evaluation and Gender-Related Differences

“…OCL affects talar articular cartilage and subchondral bone (SB), and worldwide, 50% of patients with ankle sprains and two out of three patients with chronic lateral ankle instability are affected by OCL [ 3 , 4 ]. Talar dome OCL has an incidence of 0.9% among all talar OCL and can be idiopathic or a consequence of ankle trauma, which can be classified as acute (for trauma that occurred 6 weeks before) or chronic (for trauma that occurred earlier) [ 5 , 6 , 7 ]. Usually, OCL is localized in the posteromedial aspect of the talus and, unlike knee OCL, spreads deeper into SB, causing a higher frequency of subchondral cysts [ 8 ].…”