Talar dome (cartilage, subchondral bone)-Osteochondral lesion, tibiotalar joint

2011 ◽  
Author(s):  
Eric Geusens
Keyword(s):  
Subchondral Bone ◽  
Osteochondral Lesion ◽  
Talar Dome ◽  
Tibiotalar Joint

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 Patofisiologi dan Tatalaksana Osteochondral Lesion of the Talus

2019 ◽  
Vol 1 (2) ◽  
pp. 45
Author(s):  
Maghrizal Roychan ◽  
Andre Triadi Desnantyo
Keyword(s):  
Ct Scan ◽  
Cartilage Repair ◽  
Osteochondral Lesion ◽  
Operative Therapy ◽  
Cartilage Regeneration ◽  
Osteochondral Lesions ◽  
X Rays ◽  
Talar Dome ◽  
Operative Techniques ◽  
Reduced Space

ABSTRAKPenyakit Osteochondral Lesion of the Talus (OLT) adalah kelainan pada tulang talus di lapisan subchondral yang berupa lesi osteochondral pada talar dome dengan konsekuensi abnormalitas pada tulang rawan sendi talar. Pasien biasanya datang berobat ke tenaga kesehatan dengan keluhan yang tidak spesifik dan dengan gejala seperti nyeri pada pergelangan kaki, bengkak serta berkurangnya berkurangnya ruang gerak. Penegakan diagnosis bisa dilakukan dengan anamnesis, pemeriksaan fisik dan pemeriksaan penunjang sederhana seperti foto X-ray maupun pemeriksaan penunjang canggih seperti CT-Scan dan MRI. Tatalaksana OLT bervariasi. Tatalaksana pada OLT tergantung dari tahapan lesi, kronisitasnya, dan keluhan simtomatis yang menyertainya. Pasien dengan keluhan simtomatis yang akut dan non-displaced sering diberikan terapi nonoperatif biasanya berupa terapi konservatif dengan imobilisasi. Lesi yang tidak berhasil atau tidak menunjukkan perbaikan dalam keluhan simtomatisnya setelah 3 sampai 6 bulan, serta lesi dengan displacement dapat direncanakan untuk terapi operatif. Ada beberapa macam tehnik operatif yang dapat dilakukan untuk menyembuhkan OLT. Tehnik operatif ini dapat dikategorikan menjadi cartilage repair, cartilage regeneration dan cartilage replacement techniques.Kata kunci: osteochondral lesion of the talus, patofisiologi, tatalaksanaABSTRACTOsteochondral Lesion of the Talus (OLT) is an abnormality in the talus bone in the subchondral layer in the form of osteochondral lesions in the talar dome with consequent abnormalities in the talar joint cartilage. Patients usually come to a health care provider with nonspecific complaints and with symptoms such as pain in the ankles, swelling and reduced space for movement. The diagnosis can be made with a history, physical examination and simple investigations such as X-rays and sophisticated investigations such as CT-Scan and MRI. The management of OLT varies. The management of OLT depends on the stage of the lesion, its chronicity, and the accompanying symptomatic complaints. Patients with acute and non-displaced symptomatic complaints are often given nonoperative therapy usually in the form of conservative therapy with immobilization. Lesions that are unsuccessful or show no improvement in symptomatic complaints after 3 to 6 months, and lesions with displacement can be planned for operative therapy. There are several types of operative techniques that can be done to cure OLT. These operative techniques can be categorized into cartilage repair, cartilage regeneration and cartilage replacement techniques. Keywords: osteochondral lesion of the talus, patophysiology, treatment

Relationship Between Bone Marrow Lesions on MRI and Cartilage Degeneration in Osteochondral Lesions of the Talar Dome

2018 ◽  
Vol 39 (8) ◽  
pp. 908-915 ◽  
Author(s):  
Tomoyuki Nakasa ◽  
Yasunari Ikuta ◽  
Mikiya Sawa ◽  
Masahiro Yoshikawa ◽  
Yusuke Tsuyuguchi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Subchondral Bone ◽  
Cartilage Degeneration ◽  
Osteochondral Lesions ◽  
Talar Dome ◽  
Mankin Score ◽  
Osteochondral Fragment ◽  
The Mean ◽  
And Cartilage ◽  
Ct And Mri

Background: In the evaluation of osteochondral lesions of the talar dome (OLT), bone marrow lesions (BML) are commonly observed in the subchondral bone on magnetic resonance imaging (MRI). However, the significance of BML, such as the histology of the overlying cartilage, is still unclear. The purpose of this study was to investigate the relationship between the BML and cartilage degeneration in OLT. Methods: Thirty-three ankles with OLT were included in this study. All ankles underwent CT and MRI and had operative treatment. The ankles were divided into 2 groups, depending on the presence of bone sclerosis (ie, with or without) in the host bone just below the osteochondral fragment (nonsclerosis group and sclerosis group). The area of BML was compared between the 2 groups. Biopsies of the osteochondral fragment from 20 ankles were performed during surgery, and the correlation between the BML and cartilage degeneration was analyzed. The remaining 13 ankles had the CT and MRI compared with the arthroscopic findings. Results: The mean area of BML in the nonsclerosis group was significantly larger than that in the sclerosis group. In the histologic analysis, there was a significant and moderate correlation between the Mankin score and the area of BML. The mean Mankin score in the nonsclerosis group was significantly lower than that in the sclerosis group. Conclusions: This study revealed that a large area of BML on MRI exhibited low degeneration of cartilage of the osteochondral fragment, while a small area of BML indicated sclerosis of the subchondral bone with severe degeneration of cartilage. The evaluation of BML may predict the cartilage condition of the osteochondral fragment. Level of Evidence: Level III, comparative series.

scholarly journals Retrograde Drilling for Osteochondral Lesion of the Talar Dome in Juvenile Patients

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Yasunari Ikuta ◽  
Tomoyuki Nakasa ◽  
Yusuke Tsuyuguchi ◽  
Yuki Ota ◽  
Munekazu Kanemitsu ◽  
...  
Keyword(s):  
Growth Plate ◽  
High Intensity ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Early Period ◽  
Fat Suppression ◽  
Talar Dome ◽  
Retrograde Drilling ◽  
The Mean

Category: Ankle, Arthroscopy Introduction/Purpose: Osteochondral lesion of the talar dome (OLT) is common condition that causes pain of ankle joint in juvenile patients. Several surgical options have been available such as excision of detached cartilage fragment, microfracture, autologous cancellous bone graft and osteochondral autografting depending on the status of OLT. Arthroscopic drilling including transmalleolar or retrograde technique could be a good option for OLT patients with stable osteochondral fragment with normal articular surface. Retrograde drilling has an advantage in preventing the iatrogenic articular cartilage injury. This study aimed to clarify the clinical outcome of the retrograde drilling for OLT in juvenile patients. Methods: Our retrospective analysis included 8 patients who underwent retrograde drilling for OLT, in 5 boys and 3 girls, with a mean age of 14.9 years (range, 11-19). Range of motion (ROM) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle- hindfoot score were evaluated as the clinical outcomes. OLTs were classified into 4 grades according to arthroscopic findings by international cartilage research society (ICRS) classification. Radiographic analysis was performed using preoperative and postoperative images. Growth plate was evaluated on plane radiographs, and the location and size of OLT were assessed on computed tomography. The high intensity area of the talus was also measured on T2 fat suppression images. Results: All 8 patients were followed with a mean follow-up period of 2 years, and they had no complication or revision surgery. The mean total ROM were 65.6° preoperatively and 67.1° postoperatively. AOFAS scale improved from 69.3 to 96.7 (p = 0.012). The ICRS 1 and 2 OLT lesions were identified arthroscopically in 5 and 3 patients, respectively. Growth plate remained open in 4 patients, and OLTs were located on the posteromedial in 7 patients, center in 1 patient. The mean size of OLT fragment was 9.8 mm, 6.8 mm and 3.5 mm in length, width and height. Coronal and sagittal T2 fat suppression images demonstrated that the high intensity area of 241.3 mm2, 554.5 mm2 at preoperative status and 190.9 mm2, 302.6 mm2 at final follow-up status. Conclusion: These findings revealed that the retrograde drilling remarkably improved clinical status in juvenile OLT patients. The high intensity area at the talus remained postoperatively, however, that did not affect clinical results. Retrograde drilling procedure should be considered for treating juvenile patients in the early period after detection of the OLT.

Clinical Results of the Multiple Drilling for Osteochondral Lesion of the Medial Talar Dome

2007 ◽  
Vol 42 (6) ◽  
pp. 750 ◽  
Author(s):  
Chung Soo Han ◽  
Duke Whan Chung ◽  
Jung Chul Hwang ◽  
Hyung Jun Cho
Keyword(s):  
Osteochondral Lesion ◽  
Clinical Results ◽  
Talar Dome

Anatomic feature of deltoid ligament attachment in posteromedial osteochondral lesion of talar dome

2017 ◽  
Vol 23 ◽  
pp. 18
Author(s):  
T. Nakasa ◽  
M. Sawa ◽  
Y. Ikuta ◽  
M. Yoshikawa ◽  
Y. Tsuyuguchi ◽  
...  
Keyword(s):  
Osteochondral Lesion ◽  
Deltoid Ligament ◽  
Talar Dome ◽  
Anatomic Feature

scholarly journals The Significance of MRI in Process Change of Osteochondral Lesion of Talus

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0004
Author(s):  
Xu Wang
Keyword(s):  
Subchondral Bone ◽  
Operative Procedure ◽  
Bone Cyst ◽  
Osteochondral Lesion ◽  
Cyst Formation ◽  
Process Change ◽  
3.0 T ◽  
Osteochondral Lesion Of Talus ◽  
3.0 T Mri ◽  
Marrow Edema

Category: Sports Introduction/Purpose: To evalute if the MRI Signals can be the predictor of osteochondral lesion of talus Methods: From Jul. 2012 to Oct. 2014, 3.0 T MRI scanning was performed in 20 cases of ankle sprain. MRI scanning was performed every 3 monthes and the followed-up time of each case was 12 months. The signal of cartilage, subchondral bone and marrow edema were recorded and analyzed comparatively. Results: The signal of marrow edema in talus body of 14 cases were decreased step by step and disappeared eventually. The time from injury to the marrow edema disappear was more than 9 months. 4 cases became III° osteochondral lesion and 2 cases have subchondral bone cyst formation. Conclusion: The reason of OLT and pain were under discussion. After sprain, what changes occured in the talus body and cartilage were under debate. How the subchondral bone cyst formation was unknown. Continuous MRI scanning may have some value in evaluation of the OLT. From the results of our study, we can see that the edema signal in most case can disappear in about 9 months. The OLT and cyst formation may resulted from violent force and no-standard conservative treatment. MRI scanning can help the surgeon decide when to perform operation and choice the operative procedure.

scholarly journals A Case of Osteochondral Autologous Graft Transplantation with Mosaicplasty for Osteochondral Lesion of the Talar Dome

2005 ◽  
Vol 54 (3) ◽  
pp. 488-492
Author(s):  
Yoko Katsushima ◽  
Etsuo Chosa ◽  
Ryuji Kuroki ◽  
Hiroaki Yano ◽  
Keitaro Yamamoto ◽  
...  
Keyword(s):  
Osteochondral Lesion ◽  
Talar Dome ◽  
Autologous Graft

scholarly journals Management of Osteochondral Lesions of the Talar Dome

2017 ◽  
Vol 11 (1) ◽  
pp. 743-761 ◽  
Author(s):  
Chamnanni Rungprai ◽  
Joshua N. Tennant ◽  
Ryan D. Gentry ◽  
Phinit Phisitkul
Keyword(s):  
Osteochondral Lesion ◽  
Osteochondral Lesions ◽  
Talar Dome ◽  
Joint Function ◽  
Bone Marrow Stimulation ◽  
Surgical Strategies ◽  
Restoration Techniques ◽  
Chondrocyte Implantation ◽  
History Of ◽  
Osteochondral Fragment

Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. 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. Arthroscopic treatment of the OLTs aims to restore ankle joint function and pain relief by the removal of the chondral or osteochondral fragment, debridement and stabilization of cartilage rim and subchondral bone, and stimulate healing of the bone and damaged cartilage. 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. This article summarizes the contemporary concepts in the clinical evaluation and treatment of OLTs with particular emphasis on surgical strategies.

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