scholarly journals Bone shape difference between control and osteochondral defect groups of the ankle joint

2016 ◽  
Vol 24 (12) ◽  
pp. 2108-2115 ◽  
Author(s):  
N. Tümer ◽  
L. Blankevoort ◽  
M. van de Giessen ◽  
M.P. Terra ◽  
P.A. de Jong ◽  
...  
2011 ◽  
Vol 39 (11) ◽  
pp. 2457-2465 ◽  
Author(s):  
Ashraf M. Fansa ◽  
Christopher D. Murawski ◽  
Carl W. Imhauser ◽  
Joseph T. Nguyen ◽  
John G. Kennedy

Background: Autologous osteochondral transplantation procedures provide hyaline cartilage to the site of cartilage repair. It remains unknown whether these procedures restore native contact mechanics of the ankle joint. Purpose: This study was undertaken to characterize the regional and local contact mechanics after autologous osteochondral transplantation of the talus. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen cadaveric lower limb specimens were used for this study. Specimens were loaded using a 6 degrees of freedom robotic arm with 4.5 N·m of inversion and a 300-N axial compressive load in a neutral plantar/dorsiflexion. An osteochondral defect was created at the centromedial aspect of the talar dome and an autologous osteochondral graft from the ipsilateral knee was subsequently transplanted to the defect site. Regional contact mechanics were analyzed across the talar dome as a function of the defect and repair conditions and compared with those in the intact ankle. Local contact mechanics at the peripheral rim of the defect and at the graft site were also analyzed and compared with the intact condition. A 3-dimensional laser scanning system was used to determine the graft height differences relative to the native talus. Results: The creation of an osteochondral defect caused a significant decrease in force, mean pressure, and peak pressure on the medial region of the talus ( P = .037). Implanting an osteochondral graft restored the force, mean pressure, and peak pressure on the medial region of the talus to intact levels ( P = .05). The anterior portion of the graft carried less force, while mean and peak pressures were decreased relative to intact ( P = .05). The mean difference in graft height relative to the surrounding host cartilage for the overall population was −0.2 ± 0.3 mm (range, −1.00 to 0.40 mm). Under these conditions, there was no correlation between height and pressure when the graft was sunken, flush, or proud. Conclusion/Clinical Relevance: Placement of the osteochondral graft in the most congruent position possible partially restored contact mechanics of the ankle joint. Persistent deficits in contact mechanics may be due to additional factors besides graft congruence, including structural differences in the donor cartilage when compared with the native tissue.


2003 ◽  
Vol 24 (4) ◽  
pp. 317-320 ◽  
Author(s):  
Dirk Schäfer ◽  
Andreas Boss ◽  
Beat Hintermann

Purpose: The accuracy of arthroscopic evaluation of the size of an osteochondral lesion in the ankle joint was assessed in 10 cadaver feet. Materials and Methods: A rectangular osteochondral defect was created in the anterior part of the talus. A 5 mm 30° arthroscope was utilized for evaluation of the size of the lesion from an anterior midline portal under carbon dioxide. Results: The size of the defect averaged 77.2±31 mm 2 (24–108 mm 2 ). The difference between area of the defect and measurement of three independent investigators averaged 52%, 49% and 49%, respectively. Conclusion: The assessment of the size of an osteochondral lesion in the ankle joint based on arthroscopy implicates over- and underestimation of the defect.


2021 ◽  
Author(s):  
Jia Li ◽  
Yezhou Wang ◽  
Yu Wei ◽  
Dan Kong ◽  
Yuan Lin ◽  
...  

Abstract (1) Background: Osteochondral lesion of the talus (OLT) is one of the common ankle injuries, which will lead to biomechanical changes in the ankle joint and ultimately affect the ankle function. The finite element analysis (FEA) was used to clarify the effect of talus osteochondral defects in different depths on the stability of the ankle joint. However, there is no clear research about the area of talus osteochondral defects that should be intervened in time. In this research, FEA is used to simulate the effect of different areas size of talus osteochondral defect on the stress and stability of ankle joint under a certain depth defect.; (2) Methods: The different area size (Normal, 2 mm* 2 mm, 4 mm* 4 mm, 6 mm* 6 mm, 8 mm* 8 mm, 10 mm* 10 mm, 12 mm* 12 mm) of osteochondral defects three-dimensional finite element model was established to simulate and calculate joint stress and displacement of the articular surface of the distal tibia and the proximal talus while the ankle joint was in the push-off phase, midstance phase and heel-strike phase; (3) Results: When OLT occurred, the contact pressure of articular surface, the equivalent stress of the proximal talus, tibial cartilage and talus cartilage did not change significantly with the increase of osteochondral defect area size in heel-strike phase below 6 mm * 6 mm, it increased gradually from 6 mm * 6 mm in midstance phase and push-off phase, and reached the maximum when the defect area size is 12 mm * 12 mm. The talus displacement also has the same tendency.; (4) Conclusions: The effect of cartilage area size defects of the talus on the biomechanics of the ankle is obvious especially in the midstance phase and push-off phase. When the defect size reaches 6 mm * 6 mm, the most obvious change in the stability of the ankle joint occurs, and the effect does not increase linearly with the increase in the depth of the defect.


Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 283-288
Author(s):  
Maurer ◽  
Stamenic ◽  
Stouthandel ◽  
Ackermann ◽  
Gonzenbach

Aim of study: To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. Methods: Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. Results: The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. Conclusion: The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.


2018 ◽  
Vol 69 (9) ◽  
pp. 2501-2507
Author(s):  
Anca Plavitu ◽  
Mark Edward Pogarasteanu ◽  
Marius Moga ◽  
Mircea Lupusoru ◽  
Florentina Ionita Radu ◽  
...  

Our objective is to develop a novel method of approaching the arthroscopic treatment of osteochondral lesions within the knee joint by using mathematics as a way of understanding the geometry involved in the knee, both in normal and degenerated knee joint surfaces. Bone and cartilage lesions are frequent, whether as a result of trauma, degenerative pathology, vascular pathology (osteocondritis dissecans) or tumoral. In all cases, a defect can be repaired arthroscopically, if it has manageable dimensions and if the surgeon has the technological means and the necessary skills, through the use of grafts (autografts or allografts). Alternatively, a lesion that may be approached arthroscopically initially could prove to be too great for repair and may need a second intervention for reconstruction with an endoprosthesis. We aim to further deepen the surgeon�s understanding of this pathology, through the use of 3D technology as a way of representing the osteochondral defect. Thus, its dimensions and position may be better understood, and the surgical intervention may be better planned out, potentially resulting in a shorter operating time and an overall superior outcome for the patient, and even potentially diminishing the number of unnecessary surgeries performed.


BMJ ◽  
1951 ◽  
Vol 1 (4721) ◽  
pp. 1494-1494
Author(s):  
J. S. Batchelor
Keyword(s):  

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