Computertomography/Robot-assisted Retrograde Drilling of Osteochondral Lesions of the Ankle Joint

2011 ◽  
Vol 10 (4) ◽  
pp. 139-143
Author(s):  
Martin Wiewiorski ◽  
Andre Leumann ◽  
Geert Pagenstert ◽  
Arno Frigg ◽  
Victor Valderrabano
Keyword(s):  
Ankle Joint ◽  
Osteochondral Lesions ◽  
Robot Assisted ◽  
Retrograde Drilling

V 46 CT-guided robotically-assisted retrograde drilling of osteochondral lesions of the ankle joint

2009 ◽  
Vol 25 (2) ◽  
pp. 148-149
Author(s):  
Martin Wiewiorski ◽  
A.L. Jacob ◽  
A. Leumann ◽  
O. Büttner ◽  
M. Kretzschmar ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Osteochondral Lesions ◽  
Ct Guided ◽  
Retrograde Drilling

scholarly journals Re-operation rate after surgical treatment of osteochondral lesions of the talus in paediatric and adolescent patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniel Körner ◽  
Christoph E. Gonser ◽  
Stefan Döbele ◽  
Christian Konrads ◽  
Fabian Springer ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bone Grafting ◽  
Cartilage Damage ◽  
Osteochondral Lesions ◽  
Retrograde Drilling ◽  
Autologous Bone Grafting ◽  
Operation Rate ◽  
Group A ◽  
Autologous Bone ◽  
Group B

Abstract Background The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents. Methods Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus. ‘Re-operation’ as the outcome measure was evaluated after a median follow-up of 42 months (range 6–117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables. Results Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13–61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001). Conclusions We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.

scholarly journals AB0858 TREATMENT ALGORITHM FOR ANKLE OSTEOCHONDRAL LESIONS AND DEFECTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1736.2-1736
Author(s):  
O. Burianov ◽  
L. Khimion ◽  
T. Omelchenko ◽  
E. Levitskyi ◽  
V. Lyanskorynsky
Keyword(s):  
Bone Marrow ◽  
Ankle Joint ◽  
Bone Marrow Cells ◽  
Traditional Approach ◽  
Treatment Algorithm ◽  
Main Group ◽  
Long Term Results ◽  
Osteochondral Lesions ◽  
Traditional Treatment

Background:traumatic ankle joint osteochondral lesions and defects (OHLD) is frequent cause of OA, chronic pain and loss of joint function; results of traditional treatment strategy are often unsatisfyingObjectives:to develop treatment algorithm for OHLD based on evaluation of previously determined main prognostic factors.Methods:the analysis of long-term (36 ± 4.5 months) treatment results of 239 patients after traumatic ankle joint OHLD revealed the following factors with the greatest predictive value (defined by PC – prognostic coefficient) for good result of treatment (defined as AOFAS function score 75-100 points): age < 40 years (PC = 8.5); size of OHLD ≤ 1.0 cm2; volume ≤ 1.5 cm3(PC = 8.0); osteoarthritis stage ≤ II (PC = 7.2). Based on these factors, a step-by-step, discrete and alternative algorithm for the choice of treatment tactics was created. The algorithm includes use of arthroscopic or open debridement, abrasive chondroplasty, bone marrow regeneration stimulation (microfracturing or tunneling), mosaic osteochondroplasty, arthroplasty or arthrodesis, the use of cellular regenerative technologies (bone marrow cells, platelet riched plasma), and others. Patients of older age with advanced OA need complex, step up approach, surgical treatment combined with regenerative cell technologies. The effectiveness of the differentiated approach to treatment was studied in 72 patients with OHLD (main group) in comparing to 72 patients in whom traditional treatment approaches were used, based on the stage of injury according to the Berndt & Hardy classification (comparison group).Results:compared to the traditional approach, the developed algorithm and treatment system allowed to half terms of hospitalization, to reduce the intensity of pain syndrome (by NRS) and increase the functional activity (by AOFAS) by 25%. In 3 years after trauma good/excellent results of treatment demonstrated 86% patients of main group and 32,2% of patients from comparing group (p<0,05).Conclusion:implementation of the developed treatment algorithm increases the number of good and excellent long-term results by 2.6 times and reduces the number of complications and unsatisfactory results by 4.9 times.Disclosure of Interests:None declared

Arthroscopy-Assisted Retrograde Drilling of Osteochondral Lesions of the Talar Dome

2005 ◽  
Vol 95 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Scott C. Nelson ◽  
Darryl M. Haycock
Keyword(s):  
Clinical Presentation ◽  
Osteochondral Lesion ◽  
Final Diagnosis ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Talar Dome ◽  
Advanced Imaging ◽  
Retrograde Drilling ◽  
High Index Of Suspicion

Traumatic ankle conditions can lead to long-term sequelae if a pathologic process is misdiagnosed. The clinical presentation of an osteochondral lesion of the talar dome requires the clinician to have a high index of suspicion, and advanced imaging is often necessary to make the final diagnosis. Treatment should be initiated once the lesion is appropriately staged by radiologic or magnetic resonance imaging. We discuss the use of arthroscopy-assisted retrograde drilling of the medial talar dome that spares the articular cartilage within the talotibial articulation. (J Am Podiatr Med Assoc 95(1): 91–96, 2005)

scholarly journals Accessibility to Talar Dome in Neutral Position, Dorsiflexion, or Noninvasive Distraction in Posterior Ankle Arthroscopy

2019 ◽  
Vol 40 (8) ◽  
pp. 978-986 ◽  
Author(s):  
Lena Hirtler ◽  
Katarina Schellander ◽  
Reinhard Schuh
Keyword(s):  
Minimally Invasive ◽  
Ankle Joint ◽  
Clinical Relevance ◽  
Arthroscopic Treatment ◽  
Osteochondral Lesions ◽  
Neutral Position ◽  
Matched Pairs ◽  
Talar Dome ◽  
Statistical Comparison ◽  
Posterior Ankle Arthroscopy

Background: Osteochondral lesions of the talus are frequent pathologies of the ankle joint. Especially through arthroscopy, the treatment is kept as minimally invasive as possible. However, there are some drawbacks as to the reachability because of the high congruency of the ankle joint. Here, either noninvasive distraction or maximal dorsiflexion may be an option for better access to the lesion. The purpose of this study was to evaluate maximal dorsiflexion compared to neutral position or noninvasive distraction of the ankle joint in the arthroscopic reachability of the talar dome. The hypothesis of this study was that maximal dorsiflexion would allow for greater accessibility of the talar dome compared to neutral position or noninvasive distraction of the joint. Methods: Twenty matched pairs (n=40) of anatomical ankle specimens were used. The effects of neutral position, maximal dorsiflexion, and noninvasive distraction of the ankle joint on arthroscopic accessibility of the ankle joint were tested. After disarticulation of the talus, reach was measured and compared between the 3 positions. Results: In neutral position, 13.7±1.2 mm of the talar dome was reached laterally and 14.0±1.0 mm medially. In maximal dorsiflexion, the distance was 19.0±1.1mm laterally and 19.8±1.4 mm medially, and in noninvasive distraction it was 16.1±1.5 mm laterally and 15.7±1.0 mm medially. The statistical comparison showed a significantly better reach in dorsiflexion laterally ( P = .003) and medially ( P = .026). Conclusion: Accessibility of the talar dome in maximal dorsiflexion was superior to that in neutral position or noninvasive distraction. Clinical Relevance: Results of this study may allow for better planning in arthroscopic treatment of osteochondral lesions of the talus.

Osteochondral Lesions of the Talus: Computer-assisted Retrograde Drilling—Feasibility and Accuracy in Initial Experiences

Radiology ◽  
2001 ◽  
Vol 218 (1) ◽  
pp. 278-282 ◽  
Author(s):  
Reto J. Bale ◽  
Christian Hoser ◽  
Ralf Rosenberger ◽  
Michael Rieger ◽  
Karl P. Benedetto ◽  
...  
Keyword(s):  
Osteochondral Lesions ◽  
Computer Assisted ◽  
Retrograde Drilling

Development of a Soft Pneumatic Sock for Robot-Assisted Ankle Exercise

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Fan-Zhe Low ◽  
Hong Han Tan ◽  
Jeong Hoon Lim ◽  
Chen-Hua Yeow
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Medical Condition ◽  
Joint Stiffness ◽  
Intermittent Pneumatic Compression ◽  
Ankle Dorsiflexion ◽  
Compression Stockings ◽  
Robot Assisted ◽  
Pneumatic Actuators ◽  
Prolonged Immobilization

Deep vein thrombosis (DVT) is a severe medical condition that affects many patients around the world, where one of the main causes is commonly associated with prolonged immobilization. Current mechanical prophylaxis systems, such as the compression stockings and intermittent pneumatic compression devices, have yet to show strong efficacy in preventing DVT. The current study aimed to develop a soft pneumatic sock prototype that uses soft extension pneumatic actuators to provide assisted ankle dorsiflexion–plantarflexion motion, so as to prevent the occurrence of DVT. The prototype was evaluated for its efficacy to provide the required dorsiflexion–plantarflexion motion by donning and actuating the prototype on simulated ankle–foot models with various ankle joint stiffness values. Our results showed that the soft extension actuators in the sock prototype provided controllable assisted ankle plantarflexion through actuator extension and ankle dorsiflexion through actuator contraction, where in our study, the actuations extended to 129.9–146.8% of its original length. Furthermore, the sock was able to achieve consistent range of motion at the simulated ankle joint across different joint stiffness values (range of motion: 27.5 ± 6.0 deg). This study demonstrated the feasibility of using soft extension pneumatic actuators to provide robot-assisted ankle dorsiflexion–plantarflexion motion, which will act as an adjunct to physiotherapists to optimize therapy time for bedridden patients and therefore may reduce the risk of developing DVT.

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