Author information: (1)Broadlawns Medical Center, Des Moines, Iowa, USA. Talar dome lesions are usually caused by … A partial fluid cleft at its posterior margin and a mild subchondral oedema suggests an unstable lesion. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. Epub 2014 Dec 11. (A) Unstable medial talar dome osteochondral lesion of the talus. 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. Diagnosis of lesions is based on imaging. Hangody L: The mosaicplasty technique for osteochondral lesions of the talus. Talar dome lesions are most common, while talar head lesions are relatively rare. 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. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 73. Initially, OLT was described and classified as ‘transchondral fractures of the talus’ by Berndt and Harty in 1959 (1) . Nelson SC, Haycock DM: Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. Osteochondral lesion of the talar dome Share | Definition. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Foot Ankle Int. 2. Approximately 10% of osteochondral talar dome lesions … 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. Patients tend to present… Osteochondral lesions of the talar dome are a common cause of ankle disability. An osteochondral injury to the talar dome produces pain at the ankle and you will … Mild joint effusion is seen at tibio-talar and subtalar joints. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Talar dome lesions are usually caused by an injury, such as an ankle sprain. Arthroscopy. 4. 11 Chondral injuries generally occur to either the anterolateral or posteromedial ankle. It is often associated with a traumatic injury such as a severe ankle sprain. A medial talar dome injury is seen on a mortise x-ray view. https://openorthopaedicsjournal.com/VOLUME/11/PAGE/743/FULLTEXT (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. Radiographs showed a suspicious area on the lateral talar dome. 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. Arthroscopy. Osteochondral lesions of the talar dome. Osteochondral lesions of the talar dome are common problems encountered in orthopaedics. Detached osteochondral lesions and loose bodies secondary to osteochondral lesions of the talar dome usually require fragment removal and debridement of the bone bed. cartilage lesions when evaluated arthroscopically.7 Etiology Many different terms have been used to describe these defects of talar articular cartilage including transchondral fracture, osteochondral fracture, osteochondritis dissecans, talar dome fracture, and flakedfracture. 5. Adjacent subtle marrow edema seen in the medial aspect of talus bone. Particulated juvenile cartilage allograft transplantation. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Background: Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Foot Ankle Clinics 8(2): 259-273, 2003. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). Medial lesions tend to be deeper and cup shaped. 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. Talar dome lesions are usually caused by … The talus is a bone in the foot that helps form the ankle joint. … Kelberine F, Frank A. Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. Free Online Library: Osteochondral lesions of the talar dome. OLTs typically are preceded by a traumatic event and generally result in vascular damage to the subchondral bone. Terminology. FIGURE 71-1 Osteochondral lesion of the talus. 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). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. “Osteo” means bone and “chondral” refers to cartilage. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. Sixteen patients (16 ankles) with symptomatic osteochondral lesions of the medial talar dome were treated arthroscopically with percutaneous retrograde drilling through the sinus tarsi. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. Osteochondral lesion of the talar dome (OCLT) can be a devastating injury that affects mobility. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Osteochondral lesion (OCL) of the talar dome is rare in children. JBJS 62(1): 97-102, 1980. 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. The recognition of a traumatic etiology has increased our understanding and management of these disorders. Anderson IF, Crichton KJ, Grattan-Smith T. Osteochondral fractures of the dome of the talus. Foot Ankle Surg. 22(7):544-51. . Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. 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. The use of various (B) Lesion debrided to stable margins. 2015 Sep;21(3):193-7. 10. “Osteo” means bone and “chondral” refers to cartilage. Etiology of these lesions is debated but trauma seems the most supported etiology. Management options are as numerous as the terms used to describe these lesions. “Osteo” means bone and “chondral” refers to cartilage. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The surgical technique allows preservation of intact articular cartilage, in contrast to traditional methods. 2012; 28(12):1902-1907. by "Bulletin of the NYU Hospital for Joint Diseases"; Health, general Anklebone Bone diseases Care and treatment Cartilage Injuries Osteochondritis Osteochondrosis Talus (Anklebone) A classification was proposed by Bemdt and Harty (1959) who found that both the medial and lateral OCL of the talus could be induced by trauma; they named this lesion transchondral fracture. Small well defined hypointense signal lesion is seen on the T1W images in the medial talar dome at subchondral region. Outcome of arthroscopic debridement and microfracture as the primary treatment for osteochondral lesions of the talar dome. Talar dome injuries such as osteochondral lesions of the talus (OLT) can occur following an ankle injury, resulting in ongoing residual ankle pain and functional disability. 2001 Jul. The incidence is similar, but lateral talar dome injuries … The incidence of osteochondral lesions of the talus is increasing because of a greater awareness of this injury following ankle trauma. Injuries to the talar dome should be suspected when an athlete presents with chronic ankle pain following an injury to the ankle. Mandracchia VJ(1), Buddecke DE Jr, Giesking JL. 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. 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. 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. Kouvalchouk et al. 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. ( 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. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. 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. 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. We have … This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). 3. Talar osteochondral lesions tend to involve the medial and lateral corners of the talar dome. Canale ST, Belding RH: Osteochondral lesions of the talus. “Osteo” means bone and “chondral” refers to cartilage. 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