Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. Conservative management, including weight-bearing restrictions, physical therapy, and supportive measures, often is first-line treatment. A medial talar dome injury is seen on a mortise x-ray view. (A) Unstable medial talar dome osteochondral lesion of the talus. 22(7):544-51. . Talar dome lesions are usually caused by … Series shows the case of a 25-years-old man, a sports and physically active patient, with chronic ankle pain, a lateral talus osteochondral lesion (OCL), and chronic ankle instability. Treatment of Osteochondral Lesions of the Talar Dome James W. Stone MD Key Points Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. An osteochondral lesion of the talus (OLT) is defined as an injury to the talar dome that results in partial or total separation of the articular cartilage or subchondral bone. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). Background: Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Foot Ankle Clinics 8(2): 259-273, 2003. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. Arthroscopy. (B) Lesion debrided to stable margins. Epub 2014 Dec 11. https://openorthopaedicsjournal.com/VOLUME/11/PAGE/743/FULLTEXT Radiographs showed a suspicious area on the lateral talar dome. Diagnosis of lesions is based on imaging. The talus is a bone in the foot that helps form the ankle joint. by "Bulletin of the NYU Hospital for Joint Diseases"; Health, general Anklebone Bone diseases Care and treatment Cartilage Injuries Osteochondritis Osteochondrosis Talus (Anklebone) The recognition of a traumatic etiology has increased our understanding and management of these disorders. Arthroscopy. Medial lesions are more common than the lateral ones and typically located at the posteromedial talar dome, with a typicall deep - cupshaped figure. 73. 9. onnenwerth MP, Roukis TS. It is often associated with a traumatic injury such as a severe ankle sprain. (A) Sagittal and (B) axial T2-weighted images of the ankle show an osteochondral lesion at the medial talar dome at the equator (midline) of the anteroposterior (AP) dimension. 4. Osteochondral lesion of the talar dome Share | Definition. Foot Ankle Surg. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. Osteochondral lesions of the talar dome are common problems encountered in orthopaedics. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Osteochondral lesions of the talar dome are a common cause of ankle disability. OLTs typically are preceded by a traumatic event and generally result in vascular damage to the subchondral bone. A comprehensive review with retrospective study. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Kelberine F, Frank A. Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases. Mandracchia VJ(1), Buddecke DE Jr, Giesking JL. 2012; 28(12):1902-1907. The incidence of osteochondral lesions of the talus is increasing because of a greater awareness of this injury following ankle trauma. JBJS 62(1): 97-102, 1980. 2. Injuries to the talar dome should be suspected when an athlete presents with chronic ankle pain following an injury to the ankle. Kouvalchouk et al. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. 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. The lesion’s location does not technically limit the ability to perform the conventional surgical treatments discussed in this chapter as it does other restorative procedures, such as osteochondral autograft or allograft transplantation (i.e., osteoarticular transfer system [OATS]) or autologous chondrocyte implantation (ACI), which require greater access to the talar dome. “Osteo” means bone and “chondral” refers to cartilage. All … A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 2015 Sep;21(3):193-7. Talar dome lesions are usually caused by an injury, such as an ankle sprain. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5.It is often used synonymously with osteochondral injury/defect and in the pediatric population. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). FIGURE 71-1 Osteochondral lesion of the talus. JAPMA 95(1): 91-96, 2005. ( C ) This corresponds to Zone 4 in the grid proposed by Elias and colleagues, 5 which was found to be the most common location for talar dome lesions and the location of the largest and deepest lesions. Anderson IF, Crichton KJ, Grattan-Smith T. Osteochondral fractures of the dome of the talus. Nelson SC, Haycock DM: Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. Talar dome lesions are most common, while talar head lesions are relatively rare. Adjacent subtle marrow edema seen in the medial aspect of talus bone. With regard to the side of the lesion, observations have demonstrated consistently that lateral sided lesions are predominantly post-traumatic and the medial lesions are largely due to atraumatic causes, the results in our study also corroborate with the same findings. Initially, OLT was described and classified as ‘transchondral fractures of the talus’ by Berndt and Harty in 1959 (1) . It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The incidence is similar, but lateral talar dome injuries … In general, the edges of the lesion are debrided to healthy, well-attached articular cartilage, and the base of the lesion is abraded to viable, bleeding subchondral bone. Medial lesions tend to be deeper and cup shaped. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. We have … 5. Terminology. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Assenmacher JA, Kelikian AS, Gottlob C. Arthroscopically assisted autologous osteochondral transplantation for osteochondral lesions of the talar dome: an MRI and clinical follow-up study. Osteochondral lesion (OCL) of the talar dome is rare in children. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. Author information: (1)Broadlawns Medical Center, Des Moines, Iowa, USA. Procedures for the treatment of osteochondral lesions of the talus, including debridement of the joint, shaving of fibrillated cartilage, and resection or perforation of subchondral bone in the last decade, have been performed arthroscopically with very low morbidity. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. Free Online Library: Osteochondral lesions of the talar dome. in 1986. in 1984 emphasized that these lesions should not be called as osteochondritis dissecans but be grouped under a broader term “osteochondral lesions of the talar dome.” The arthroscopic treatment of these lesions was first described by Parisien and Pritsch et al. Canale ST, Belding RH: Osteochondral lesions of the talus. “Osteo” means bone and “chondral” refers to cartilage. … Small well defined hypointense signal lesion is seen on the T1W images in the medial talar dome at subchondral region. The surgical technique allows preservation of intact articular cartilage, in contrast to traditional methods. 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. 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