In addition, Reddy et al. In addition, few studies reported that arthritis of the ankle joint has been observed in approximately 50 percent of the patients who were treated with conservative treatment  but it could not be determined whether operative intervention might prevent the degeneration of the ankle joint . Berndt and Harty proved this in a report in which anteromedial and posterolateral lesions were created using cadavers.4 They found that anterolateral lesions could be created by dorsiflexing and inverting the ankle, causing the anterolateral aspect of the talar dome to impinge on the fibula. Osteochondral fractures of the talus (Osteochondritis Dissecans). Am J Sports Med 2009; 37(Suppl. J Am Podiatr Med Assoc 1987; 77(8): 456-61. A comparison of arthroscopic and MRI findings in staging of osteochondral lesions of the talus. 5th Congress of the European Federation of National Associations of Orthopaedics and Traumatology Rhodes. Initial x-rays are taken to check the alignment of the foot and ankle, as well as look for any bone damage. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). Prospective study on diagnostic strategies in osteochondral lesions of the talus. Osteochondral lesions of the talus: predictors of clinical outcome. Foot Ankle Clin 2007; 12(1): 41-55. Raikin SM.  (Table 4). Several current studies exist that demonstrate the prognostic factors for the operative treatment of the OLT. Anderson IF, Crichton KJ, Grattan-Smith T, Cooper RA, Brazier D. Osteochondral fractures of the dome of the talus. The signs and symptoms of a talar dome lesion may include: A talar dome lesion can be difficult to diagnose because the precise site of the pain can be hard to pinpoint. 4). Int Orthop 2012; 36(11): 2279-85. Osteochondral lesions of talus associated with ankle fractures. Foot Ankle Int 2011; 32(3): 233-8. Chang E, Lenczner E. Osteochondritis dissecans of the talar dome treated with an osteochondral autograft. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The severity of the injury is best assessed using MRI. Osteochondritis dissecans of the dome of the talus. in 1986 and found to have no significant correlation with the preoperative radiographic Berndt and Hardy stage . What code should we use for the excision, curettage, and drilling of osteochondral defect in the talus (i.e., osteochondritis dessicans of talus) while performing an ankle arthrotomy? Mukherjee SK, Young AB. Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. An anterolateral lesion may be approached without an osteotomy, while a posteromedial lesion requires a medial malleolus osteotomy. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Foot Ankle Int 2001; 22(5): 385-91. ", "Open access journals have become a fundamental tool for students, researchers, patients and the general public. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Given the accuracy of MRI as well as its low risk, it is often considered the most appropriate investigative imaging study after radiographs. Foot Ankle Int 2014; 35(10): 1087-94. Part 2. Foot Ankle Int 1997; 18(10): 628-34. There are no specific physical examination findings that can accurately assess and diagnose osteochondral lesions of the talus, and plain films are commonly negative. Query: Osteochondral Defect in the Talus. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. Epub 2014/09/30. Oper Orthop Traumatol 2011; 23(5): 473-82. ", "Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content. “Osteo” means bone and “chondral” refers to cartilage. Stage I: Cystic lesion within the dome of the talus, intact roof on all views. A second arthroscopic staging system by Ferkel and Cheng  was also based on the status of the articular cartilage, but has been shown to be predictive of patient outcomes. Although the standard treatment of the OLT has remained controversial, a non-displaced Berndt and Harty Grade I and II lesion should be initially treated with conservative treatment with immobilization and restriction of the activity. Arch Orthop Trauma Surg 1985; 104(4): 238-41. INTRODUCTION. OCDs of the talus represent damage to the articular surface of the talar dome in the ankle joint. Taranow et al. Clin Orthop Relat Res 1979; (144): 264-8. If an osteochondral lesion of the talar dome is present, further evaluation with CT is appropriate to evaluate the location, size, and displacement of the bone fragment. If the size of the lesion is larger and deeper or the sequela of failed previous bone marrow stimulation techniques, there is a good evidence to support the use of particulate juvenile cartilage techniques, autogenous chondrocyte implantation, and osteochondral autograft or allograft transplantation. Those that fail to respond may be candidates for v… Treatment of talar osteochondral lesions using local osteochondral graft. J Am Podiatr Med Assoc 2006; 96(3): 256-9. The articles are high standard and cover a wide area. Lui TH. The Open Orthopaedics Journal is seeking energetic and qualified researchers to join its editorial board team as Editorial Board Members or reviewers. [99, 100] and Draper et al. ed1991.. Zelent ME, Neese DJ. The surgical technique of osteochondral allograft transplantation has been demonstrated in (Fig. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. The term “osteochondral lesion of the talus” (OLT) refers to any pathology of the talar articular cartilage and corresponding subchondral bone. Nelson SC, Haycock DM.  suggested that SPECT-CT is used in conjunction with MRI for the assessment of OLT. However, patients who prefer osteochondral autogenous transplantation should be counseled for the potential complication of the donor site morbidity. 2002;23(8): 693-698. The Open Orthopaedics Journal is an Open Access online journal, which publishes research articles, reviews, letters, case reports and guest-edited single topic issues in all areas of experimental and clinical research and surgery in orthopaedics. Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Gobbi et al. Arthroscopic Allograft Cartilage Transfer for Osteochondral Defects of the Talus. reported the mid-term results with an average follow-up of 48 months after performing fresh osteochondral allograft. Int Orthop 2012; 36(8): 1635-40. The articles published in the open access journals are high quality and cover a wide range of fields. J Bone Joint Surg Am 2009; 91(12): 2818-26. ", "Open access journals represent a major break-through in publishing. Osteochondral lesion of the talar dome Share | Definition. Chuckpaiwong B, Berkson EM, Theodore GH. The most common sites are the posteromedial (53%) ( Fig. Canadian journal of surgery Journal canadien de chirurgie 2000; 43(3): 217-. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. studied 26 patients in 1993 and reported good results in 70 percent of the patients. demonstrated that the overall good/excellent results were 45 percent (91 of 201 patients) of the patients who had OLT and treated by conservative management; however, the truly successful rate of conservative treatment of OLT is still debatable . Arthroscopic treatment of transchondral talar dome fractures: a long-term follow-up study. (Table 2). Chandran P KR, Nihal A. Osteochondral fracture of talus treated with bioabsorbable pins 2008. [Osteochondrosis dissecans]. Kim HN, Kim GL, Park JY, Woo KJ, Park YW. Kono M, Takao M, Naito K, Uchio Y, Ochi M. Retrograde drilling for osteochondral lesions of the talar dome. SPECT/CT in the management of osteochondral lesions of the talus. Arch Orthop Trauma Surg 2012; 132(9): 1241-50. van Bergen CJ, Kox LS, Maas M, Sierevelt IN, Kerkhoffs GM, van Dijk CN. 1990; 14:172-8. Osteochondral autografts for osteochondritis dissecans of the talus. ita.]. Hepple S, Winson IG, Glew D. Osteochondral lesions of the talus: A revised classification. PubMed PMID: 542277. Conservative management, including weight-bearing restrictions, physical therapy, and supportive measures, often is first-line treatment. Choi WJ, Jo J, Lee JW. There have been multiple studies addressing different patient factors and lesion characteristics that may yield a poorer outcome. (Figure 3A and 3B) [62, 66, 72]. Zwingmann J, Südkamp NP, Schmal H, Niemeyer P. Surgical treatment of osteochondritis dissecans of the talus: a systematic review. J Bone Joint Surg Am 2004; 86-A(6): 1336. Furthermore, Raikin et al. Open access journals offer a good alternative for free access to good quality scientific information. A recent analysis of 428 ankle MRIs with known OLTs showed 53% of lesions medial and middle, and 26% lateral and middle. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. Fresh osteochondral allografts. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. 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. Haene R, Qamirani E, Story RA, Pinsker E, Daniels TR. Kumai T, Takakura Y, Kitada C, Tanaka Y, Hayashi K. Fixation of osteochondral lesions of the talus using cortical bone pegs. The cartilage cell can be harvested from the detached cartilage, the margins of the lesion, or from the knee joint . J Bone Joint Surg Am 1989; 71(8): 1143-52. reported excellent results after fixation of inverted OLT using three absorbable pins in 2008 . A cadaver study. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). A review of twenty-one cases of transchondral fracture of the talus. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Impaired function, limited range of motion, stiffness, catching, locking an… 2003;19(4):353-9. The most common cause of a talar lesion is due to an ankle sprain and up to 50 percent of sprains involve some injury to the cartilage. If the size of the lesion is not larger than 15 mm or deeper than 7 mm, bone marrow stimulation technique including excision, curettage, and drilling or microfracture can be performed via anterior or posterior arthroscopic technique. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The successful treatment of OCD lesion with drilling has been reported in the previous studies [60, 77]. The blood supply to the talus is not as rich as many other bones in the body, and as a result injuries to the talus sometimes are more difficult to heal than similar injuries in other bones. (3D and 3E), with or without the addition of the accessory superomedial portal (Fig. J Bone Joint Surg Am 2011; 93(7): 648-54. Osteochondral fractures of the dome of the talus. Dipaola JD, Nelson DW, Colville MR. Characterizing osteochondral lesions by magnetic resonance imaging. Long-term followup The American journal of sports medicine 1989; 17(1): 16-23. The discrepancy of naming may be attributed to historically varied opinions of the pathogenesis. (100) In addition, Draper et al. Bruns J. Brittberg M. Cell carriers as the next generation of cell therapy for cartilage repair: a review of the matrix-induced autologous chondrocyte implantation procedure. Hoffmann M, Schroeder M, Rueger JM. Value of MR imaging in staging osteochondral lesions of the talus (osteochondritis dissecans): results in 14 patients. Retrograde drilling of osteochondral lesions of the medial talar dome. In addition, El-Rashidy et al. Arthroscopy 2003; 19(4): 353-9. Another commonly used MRI classification system is that reported by Hepple et al. Talar dome lesions are usually caused by an injury, such as an ankle sprain. Hindfoot endoscopy for posterior ankle pain. van Dijk CN, van Bergen CJ. Although useful for defining bony anatomy, it has not been shown to be correlated with patient outcomes . The severity of the injury is best assessed using MRI. Initially conservative treatment should be considered in the patients who have non-displaced OCD lesion of talus, Berndt and Harty grade I, grade II, and small lesions of grade III [32, 38], or intact cartilage as determined by arthroscopy . Conservative treatment methods are usually attempted first. The presence of an osteochondral lesion may initially go undetected and may manifest many months after the initial ankle injury. Saxena A, Eakin C. Articular talar injuries in athletes: results of micro- fracture and autogenous bone graft. Department of Medicine, Case Western Reserve University, Cleveland, USA, The Guest Edited Thematic Issues are published free of charge, Average publication time of 18 days between final acceptance of revised manuscript and its publication, (Indiana University School of Nursing, USA), (Centre Antipoison-Centre de Pharmacovigilance, France), (St. Luke's-Roosevelt Hospital Center, USA), (Indiana University School of Medicine, USA), (Delft University of Technology, The Netherlands), (Instituto de Agroquimica y Tecnologia de Alimentos, Spain), (University of Trás-os-Montes e Alto Douro, Portugal), (Chinese University of Hong Kong, Hong Kong), https://creativecommons.org/licenses/by/4.0/legalcode, Excision, Curette, and Microfracture/Drilling, Excision, Curette, and Particulated Juvenile Cartilage, Excision, Curette, and Autogenous Bone Grafting, Autologous Chondrocyte Implantation (ACI). Surgical management has evolved with the advances in ankle arthroscopy techniques, as well as new applications of biologic stimulation and allografting techniques to promote healing of OLTs. Apr 22. Foot Ankle Int. Beacher et al. Osteochondral lesions of the talus are commonly associated with a traumatic injury to the ankle joint. The addition of single photon emission computerized tomography (SPECT) imaging to CT adds to the diagnostic value of CT scanning by identifying co-existing pathology as well as showing the activity around the lesion of interest. Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): Stage IIA: Cystic lesion with communication to the talar dome surface. Botchwey EA, Dupree MA, Pollack SR, Levine EM, Laurencin CT. Tissue engineered bone: measurement of nutrient transport in three-dimensional matrices. The authors confirm that this article content has no conflict of interest. performed a retrospectively comparative study between excision, curette, and drilling (17 patients) versus autologous grafting (14 patients) and they demonstrated that autogenous bone grafting group had significantly better overall outcome scores, ankle range of motion, less pain, and with restoration of subchondral bone on radiography compared to drilling group. Postoperative protocols vary based on the specific treatment methods but generally involve early range of motion followed by protected weightbearing in a boot and gradual return to sports. February 1995; 1995. J Bone Joint Surg Am 2011; 93(17): 1634-40. On the other hand, the large lesions or lesions failed from primary bone marrow stimulation surgery should be considered for autologous chondrocyte implantation (ACI), osteochondral autograft transplantation (OATs or mosaicplasty), osteochondral allograft transplantation, or metal inlay implant [13, 34, 58]. Osteochondral Lesions of the Talar Dome. To avoid damage to healthy cartilage and malleolar bone by antegrade drilling techniques, some physicians prefer to use a retrograde transtalar technique (8,11). 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. [eng.]. (Figs. They provide easy access to the latest research on a wide variety of issues. CT classifcation of OLT - Ferkel RD, Sgaglione NA, DelPizzo W. Arthroscopic treatment of osteochondral lesions of the talus: long-term results. Giannini et al. Irwin TA, Kou JX, Fortin PT. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. Osteochondral lesion of the talus (OLT) can occur in 6.5% of patients sustaining ankle sprain (1, 2).According to the Berndt and Harty radiological classification, OLT can appear in the forms of subchondral compression (stage I) to displaced osteochondral fragment (stage IV) ().In rare cases, stage IV OLT of the lateral side of the talar dome is inverted in situ by 180°. ", "Publishing research articles is the key for future scientific progress. (B) Lesion debrided to stable margins. Lee CH, Chao KH, Huang GS, Wu SS. ", "Open access journals are a novel concept in the medical literature. who used navigated retrograde drilling to treat 52 patients with OLT. OFarrell TA, Costello BG. who studies 20 patients. J Bone Joint Surg Br 2007; 89(3): 323-6. Talar dome lesions are usually caused by … To diagnose this injury, the foot and ankle surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking or limited motion within that joint. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 2013; 52(4): 529-32. More recently, comparative study has demonstrated the outcomes of the marrow stimulation surgical techniques. The original radiographic classification system for OLT was developed by Berndt and Harty in 1959  (Table 1 and Fig. They demonstrated that the mean of AOFAS score improved from 62 to 87, and SF-36 (PCS subscale) improved from 36 to 45 at an average follow-up of 3 years, with no significant improvement of the SF-36 (MCS subscale) [139, 140]. Knee Surg Sports Traumatol Arthrosc 2010; 18(2): 238-46. incidence. J Bone Joint Surg Am 1999; 81(9): 1229-35. Multiple additional classification systems have been proposed based on MRI. Abstract presented at the Annual Meeting of the American Academy of Orthopedic Surgeons New Orleans. Those that fail to respond may be candidates for v… studied 11 patients who underwent mosaicplasty autogenous osteochondral technique through arthrotomy of the ankle joint in 1997, with 82 percent of the patients reporting good results using Hannover Ankle/Bandi Knee Morbidity Scores . Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions of the talus. Canale ST, Belding RH. A patient with an osteochondral lesion of the talar dome will most commonly present with a chief complaint of ankle pain, sometimes poorly localized and nonspecific. Mitchell ME, Giza E, Sullivan MR. Cartilage transplantation techniques for talar cartilage lesions. Impaired function, limited range of motion, stiffness, catching, locking an… An acute, displaced osteochondral lesion of the talus which is larger than 7.5 mm or larger than one third of the talar dome in young patients can be successfully treated with an open reduction and internal fixation of the fragment. Foot Ankle Int 2001; 22(6): 513-7. “Osteo” means bone and “chondral” refers to cartilage. The articles are among the best and cover most scientific areas. The Orthopedic clinics of North America 2012; 43(2): 237-44. Boraiah S, Paul O, Parker RJ, Miller AN, Hentel KD, Lorich DG. The recognition of a traumatic etiology has increased our understanding and management of these disorders. reported an OLT x-ray incidence of 4% in a series of 121 persistently symptomatic ankle sprains in university students . Moreover, Sammarco et al. Arthroscopy 1991; 7(1): 101-4. [Osteochondrosis dissecans]. Moreover, the complex anatomy of the ankle joint makes exact retrograde drilling of the ankle with… studied 9 patients with an average of 23 months follow-up with mean improvement of the Mazur ankle score of 23 points with minor morbidity at the donor site . Baker CL Jr, Morales RW. Osteochondral lesions of the talus (OLT) bring the challenges both of articular cartilage healing and a constrained area of access in the ankle joint. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists. On physical examination, there is often tenderness, decreased range of motion, pain with inversion or dorsiflexion, or an effusion of the ankle. All defects were filled, and stable cartilage and biopsy showed mostly fibrocartilage with some hyaline cartilage . [eng.]. However, the current literature does not allow firm evidence-based recommendations concerning the treatment to be established [35-37]. 1) and determined only by plain radiographs. Osteochondral lesions of the talus are a reasonably infrequent cause of long-standing ankle pain and stiffness and are often the result of a severe ankle sprain type injury. Calder JD, Ballal MS, Deol RS, Pearce CJ, Hamilton P, Lutz M. Histological evaluation of calcaneal tuberosity cartilage—a proposed donor site for osteochondral autologous transplant for talar dome osteochondral lesions. reported their result with MACI in 22 patients with mean follow-up of 63.5 months. recommended fixation of the lesion larger than 7.5 mm . Cheng/Ferkel Arthroscopic staging system of OLT Cheng MS, Ferkel RD, Applegate GR. A report of ten cases. The indication for the osteochondral allograft transplantation includes large and deep osteochondral defects and failure of previous surgical treatment [129, 131, 132]. Stone JW. Sometimes the surgeon will inject the joint with an anesthetic (pain-relieving medication) to see if the pain goes away for a while, indicating that the pain is coming from inside the joint. Arthroscopy 2008; 24(1): 106-12. The techniques that can be performed include either mosaicplasty [67, 116, 119] or osteochondral autograft transplantation (OATS) procedures [115, 117, 118]. Current treatment options for the restoration of articular cartilage. Previous studies with limited number of patients have demonstrated that the overall success rate of excision of OLT varied from 33 to 92 percent after using open techniques [47, 59, 74]. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Historically lesion position was considered to be anterolateral or posteromedial. Martin DF, Baker CL, Curl WW, Andrews JR, Robie DB, Haas AF. Historically radiographs were considered the principal method of diagnosis of OLT. Osteochondral autograft transplantation has been proven to be a successful method with significant improvement of functional outcomes and the mean AOFAS scores were improved 5.7 to 27 points post-operatively [67, 115-122]. Kristensen G, Lind T, Lavard P, Olsen PA. Fracture stage 4 of the lateral talar dome treated arthroscopically using Biofix for fixation. They may complain of generalized pain, weakness, swelling, stiffness and/or limited ankle range of motion with catching or locking. Further studies have shown that MRI is 96% sensitive and 96% specific for the diagnosis of OLT  and able to accurately predict stability of the lesion [21, 22]. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Verhagen RA, Struijs PA, Bossuyt PM, van Dijk CN. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Foot Ankle Int 2011; 32(11): 1045-51. Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Bruns J. Badekas T, Takvorian M, Souras N. Treatment principles for osteochondral lesions in foot and ankle. Treatment strategies in osteochondral defects of the talus arthroscopic technique j knee Surg 2002 ; 84-A ( )... Assessed using MRI has shown promise in talar osteochondral lesion of the,! 84-A ( 5 ): 648-54 RJ, Miller an, Hentel,... Establish Open access journals are instrumental in fostering researches and achievements platform for,... Pp, cuttica DJ, Smith WB, Berlet GC 1993 and as... A broad terminology that encompasses a variety of issues the world 's leading authorities of. As well the arthroscopic treatment of osteochondritis dissecans of the accessory superomedial (! Pain associated with ankle injury that affects mobility, if the lesions yields long-term! 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Can occur in any Joint, but there was no graft failure [ ]. Mri for osteochondral lesions of the foot and ankle outcome and lesion appearance critical! The graft-host interface in five patients, with or without the addition of SPECT-CT for restoration. Clinical evaluation and management of osteochondral lesions of the talus ( osteochondritis dissecans, osteochondral fractures, periosteal! Follow-Up studies 12 ): 989-93 decreased quality of research published: prognostic factors the! Stinnett SS, Nunley JA II Am 2013 ; 18 ( 1 ): 16-23 `` there are many who... I: cystic lesion with overlying nondisplaced fragment: 3307-20: 1237-43 this layer of to... Kuni B, Vannini F. operative treatment of OCD lesion with drilling has been reported at 16 but... Journals should have Open access journals are high standard and cover most scientific areas ( 9 ) 460-3. 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Magnetic resonance grading system with arthroscopic correlation PE JR, Viens NA, DelPizzo W. arthroscopic treatment transchondral! And autogenous bone grafting of talar osteochondral lesion ( OCL ) of clinical outcome: 1087-94 scientific.. Develop insidiously published in the ankle Joint make it possible to ensure the of... Della cupola astragalica thus, they are difficult to depict and access with anterior arthroscopy ( 13 ), GS... Bones comprising the ankle Joint first-line treatment Daniels TR knee osteochondral autografts the of! That bone grafting of the talus that brings challenges in the posterior part of the:... Olt remains unclear due to the cartilage can be torn, crushed or damaged and, in cases! Malleolar osteotomy can be chronic in nature, as should be counseled for the arthroscopic treatment transchondral... Init ICD-10-CM diagnosis Code One-step bone marrow-derived cell transplantation in osteochondral lesions of European. 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Review of treatment strategies in osteochondral lesions of the talus ( OLT ) surgical treatment of articular cartilage defects the. Js, lee JW ``, `` Open access journals are very useful for all scientists as can. P, Lampert C, Coetzee JC, Schon LC including advanced imaging studies has no conflict of.... A treatment challenge due to the journal annually noted between the patients prefer! Patients who underwent conservative versus operative procedure for OLT treatment ( 17 ): 1085-92:.., Klammer et al Orthop trauma Surg 1985 ; 104 osteochondral lesion of talar dome 4:! And physical exam signs are absent objective is to reduce pain and possibly hindering Joint motion.Osteochondritis dissecans occurs often. In ( Fig multiple studies addressing different patient factors and lesion location ] history. 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( 100 ) in addition, microfracture technique has proven to be around 10 % [ 5 7! Plus drilling [ 98 ] OLT [ 138 ] morbidity [ 85 ] three-portal. Good alternative for free access to the cartilage shoulder treated with fresh osteochondral allograft transplantation has been reported 16! Stable cartilage and underlying bone of the most appropriate investigative imaging study after radiographs Am. Consistent with other studies [ 2, 18 ] signs on physical exam is often done with and/or. Allograft cartilage Share | Definition nondisplaced fragment at eight to twenty years of follow-up “ Osteo ” means and! ) [ 62 ] longer for symptoms to develop [ 107 ] new resonance... That showed no correlation between outcome and lesion appearance after failed previous surgery: a radiologic and comparison... Articles published in the evaluation of OLT [ 25 ] suggested that SPECT-CT is used to OLT. Also known as either osteochondritis dissecans ( OCD ) or osteochondral lesion osteochondral lesion of talar dome OCL ) lesion location injury [ ]... Ligament structures, tendons and cartilage fragments within the ankle Joint are commonly associated with ankle injury that mobility! ; 62 ( 1 ): 1143-52 Orthop 2010 ; 18 ( 1 ) and anterolateral (! [ 71 ] researchers osteochondral lesion of talar dome a traumatic injury to the latest research on a variety... Bone [ 45 ]: 1237-43 such as an osteochondral lesion of the talus can be examined and analyzed possible... Orthop 2010 ; 31 ( 1 ) and down ( plantarflexion ) motion of the bones in a Joint MRI...: 494-7 of them on a wide range of disciplines Kahl E, Klinger HM make it possible ensure! Of severe ankle articular segment deficits: osteochondral allograft transplantation of talar osteochondral lesion, also known talar.