Professional network for orthopaedic surgeons designed to improve orthopaedic education and collaboration However, 4 (50%) of the 8 patients underwent additional surgical procedures, including debridement and revision medial malleolar osteotomy. The elbow joint is made up of the upper arm bone called the humerus and two forearm bones called the radius and the ulna. Nonoperative treatment for acute, nondisplaced osteochondral lesions of the talus and cystic lesions has been associated with successful clinical results in about 50% of cases5,24,25. 2009 Nov;37(Suppl 1):105S-11S. Autologous chondrocyte implantation for the treatment of chondral and osteochondral defects of the talus: a meta-analysis of available evidence. The plug was taken from either the medial or lateral talar facet, and the largest plug obtained was 8 mm in diameter. Haene R, Qamirani E, Story RA, Pinsker E, Daniels TR. 52. • von Knoch F et al. Magnan B, Samaila E, Bondi M, Vecchini E, Micheloni GM, Bartolozzi P. Three-dimensional matrix-induced autologous chondrocytes implantation for osteochondral lesions of the talus: midterm results. 38. 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). Published reports on ACI typically have described favorable results52,54-56. The purpose of this study was to evaluate the clinical and radiographic outcomes of conservative and primary surgically treated osteochondral talar defects in skeletally immature children. 51. As the cartilage detaches from the underlying pathological subchondral surface, cartilage flaps and loose bodies can develop, leading to eventual synovitis, mechanical symptoms, and progressive pain8. Orthobullets. 22(5):385-91. . The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. 77. Orthobullets | 357 pengikut di LinkedIn. 1993 Jan-Feb;21(1):13-9. 2014; 40(10):2530–6. 2006 Sep;34(9):1450-6. Please try after some time. Eur J Radiol. This occurs when a small piece of bone and cartilage in a part of a joint separates from the bone around it. Cystic lesion with communication to talar dome surface, 2a. 58. Epub 2009 Apr 8. Loomer R, Fisher C, Lloyd-Smith R, Sisler J, Cooney T. Osteochondral lesions of the talus. The location and containment of the osteochondral lesion of the talus also may be implicated in the prognosis following the use of bone-marrow-stimulation techniques. Osteochondral defects of the talus occur predominantly on the talar dome, which is the uppermost part of the talus. 2010 Jan;31(1):90-101. The other name that gets associated with this problem is Osteochondritis Dissecans. 34. Epub 2013 Apr 10. 50. 71. Scaffolds (hyaluronic acid membrane or porcine collagen powder scaffold) were prepared with 2 mL of concentrated bone marrow aspirate and 1 mL of platelet-rich fibrin gel (to provide growth factors). An osteochondral defect that is in the early stages may be suitable for a repair technique to keep the native bone and cartilage. Despite the reported improvement, half of the patients reported knee pain and most patients (10 of 12) had development of recurrent ankle lesions with associated joint degeneration. In grown children and young adults, OCD can have more severe effects. Ogilvie-Harris DJ, Sarrosa EA. Microfracture leads to the formation of fibrocartilage (mainly composed of type-I collagen with additional contributions from type-II, III, IX, and X collagen29) as opposed to native hyaline cartilage (mainly composed of type-II collagen). Choi et al.37, in a corroboratory study, concluded that microfracture should be used for the treatment of lesions with a maximum size of 150 mm2 as seen on MRI in order to increase the likelihood of obtaining a clinically successful result. Similarly, Savva et al.34 reported that patients who underwent repeat microfracture had improved American Orthopaedic Foot & Ankle Society (AOFAS) scores after nearly 6 years of follow-up. 84. The patient's osteochondral defect in the posterolateral aspect of the talus was identified. 1999 Nov-Dec;15(8):809-12. Review Article with Critical Analysis Component. There was significant improvement in AOFAS scores (p < 0.05) for both the hyaluronic acid and porcine collagen scaffold groups at all time points up to 2 years and no difference in AOFAS scores between the scaffold types. Dr. Ebraheim’s educational animated video describes Osteochondral Lesions of the Talus. 2003 Dec;19(10):1061-7. McCoy AM, Toth F, Dolvik NI, Ekman S, Ellermann J, Olstad K, Ytrehus B, Carlson CS. 31. 2001 Jun;22(6):513-7. 26. 56. Chuckpaiwong B, Berkson EM, Theodore GH. PDF Version. 72. Treatment for an osteochondral defect depends on what the cartilage surface looks like on MRI. Anderson IF, Crichton KJ, Grattan-Smith T, Cooper RA, Brazier D. Osteochondral fractures of the dome of the talus. J Bone Joint Surg Am. 2007 Oct;35(10):1680-7. 1987 Jan;69(1):89-92. Localized osteonecrosis of the subchondral plate, resulting from either repetitive microtrauma to the subchondral plate or the disruption of the anastomosing vessels between the epiphyseal cartilage and bone during development, has been implicated in the development of osteochondritis dissecans7. Fresh osteochondral allograft for the treatment of cartilage defects of the talus: a retrospective review. In summary, lesion chronicity and associated arthrosis may serve as prognostic factors following bone-marrow stimulation. Listen wherever you get your podcasts! 78. Comparison of early versus delayed weightbearing outcomes after microfracture for small to midsized osteochondral lesions of the talus. An osteochondral injury is an injury to the smooth surface on the end of bones, called articular cartilage (chondro), and the bone (osteo) underneath it. 2006 Feb;88(2):303-8. Postoperative management continues to be an area of contention. 2014.42:635-640; Wall EJ, et al. When talar lesions are associated with subchondral cysts but intact overlying cartilage, retrograde drilling alone can result in excellent clinical outcomes38,48,49. Epub 2014 Aug 25. J Bone Joint Surg Am. Giannini S, Buda R, Vannini F, Cavallo M, Grigolo B. One-step bone marrow-derived cell transplantation in talar osteochondral lesions. Osteochondritis dissecans: editorial comment. 2008 Jan;24(1):106-12. CASES (8) Osteochondral lesion of the knee (C2536) Knee & Sports - Osteochondritis Dissecans E 3/18/2016 459 . Ankle fractures pose an even greater threat, with Leontaritis et al. Data is temporarily unavailable. If there are no loose pieces of bone or cartilage, your Pensacola orthopedic specialist might prescribe you one or more of the non-surgical treatment options below. 2008 Sep;36(9):1750-62. Both Magnan et al.67 and Apprich et al.68 evaluated the results of MACI on the basis of clinical outcomes and MRI findings. 87. Developing Insights in Cartilage Repair. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. We have dealt with the actual ligament injury and its repair, treatment of peroneal tendon injuries and also conservative care of ankle injuries. The detached osteochondral fragment as a source of cells for autologous chondrocyte implantation (ACI) in the ankle joint. Early symptoms are the result of softening and changes of the mechanical properties of the affected cartilage, all within the context of absent radiographic changes. Thus, early return to weight-bearing status may be warranted. Microfracture has been associated with clinical improvements in 65% to 90% of cases31-35. Haene et al.88 reported on 17 uncontained large osteochondral lesions of the talus that were treated with fresh talar allografts. J Bone Joint Surg Am. The incidence and prevalence is currently unknown as many of the lesions remain asymptomatic in both athletic and non-athletic individuals. This most common symptom of osteochondritis dissecans might be triggered by physical activity — walking up stairs, climbing a hill or playing sports. Since that time, other studies have validated these findings76,77. Outcome data are scarce because of the variety of pathological conditions for which these techniques are used as well as the fact that such data are often reported by the inventors of the techniques. Midterm results of osteochondral lesions of the talar shoulder treated with fresh osteochondral allograft transplantation. 2006 Jan;57(1):16-23. Cartilage injury with underlying fracture and surrounding osseous edema, III. 67. Autologous chondrocyte implantation (ACI) is a staged technique that often is used after unsuccessful nonoperative treatment or microfracture and currently is only offered through a single vendor (Carticel; Vericel)52. 2000 Oct;21(10):809-15. ➢ Operative treatment should be reserved for patients who have mechanical symptoms following an acute osteochondral lesion of the talus or who are not satisfied with the result after 3 to 6 months of nonoperative treatment. 41. Some error has occurred while processing your request. Anders S, Goetz J, Schubert T, Grifka J, Schaumburger J. 2012 Jul;20(7):703-11. 2002 Apr;84(3):364-8. 47. 2009 Sep;30(9):810-4. PJCAT is only available through a single vendor at this time (Denovo; Zimmer). Tegner Y, Lysholm J. 2007 Jun;28(6):669-73. J Bone Joint Surg Am. 2012 Sep-Oct;51(5):556-60. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. Microfracture was performed on the server Healing potential of stable juvenile osteochondritis dissecans Orthobullets and with. On 41 osteochondral lesions in the cartilage and underlying bone of the:... Transplantation in osteochondral defects of the bone Lee KB, Jung ST, JK. Pa, van Dijk CN open mosaicplasty through a couple of small incisions of! Authors did discourage the use of MR it is also called an OCD or an defect. With acute ankle fractures4 the reported success rates ranged from 50 % to 100 (... 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