Anderson IF, Crichton KJ, Grattan-Smith T. Osteochondral fractures of the dome of the talus. 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. 73. 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. 9. onnenwerth MP, Roukis TS. JAPMA 95(1): 91-96, 2005. 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. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. 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. Diagnosis of lesions is based on imaging. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). Kouvalchouk et al. FIGURE 71-1 Osteochondral lesion of the talus. 2. Epub 2014 Dec 11. Initially, OLT was described and classified as ‘transchondral fractures of the talus’ by Berndt and Harty in 1959 (1) . A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. 4. Osteochondral lesion of the talar dome Share | Definition. Osteochondral lesion (OCL) of the talar dome is rare in children. ( 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. Osteochondral lesions of the talar dome are a common cause of ankle disability. 2015 Sep;21(3):193-7. Radiographs showed a suspicious area on the lateral talar dome. Approximately 10% of osteochondral talar dome lesions … Hangody L: The mosaicplasty technique for osteochondral lesions of the talus. The use of various Nelson SC, Haycock DM: Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Arthroscopy. 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. All … Medial lesions tend to be deeper and cup shaped. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Background: Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. “Osteo” means bone and “chondral” refers to cartilage. Foot Ankle Surg. An osteochondral injury to the talar dome produces pain at the ankle and you will … Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. (B) Lesion debrided to stable margins. 3. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 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. 2001 Jul. “Osteo” means bone and “chondral” refers to cartilage. The surgical technique allows preservation of intact articular cartilage, in contrast to traditional methods. A medial talar dome injury is seen on a mortise x-ray view. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. “Osteo” means bone and “chondral” refers to cartilage. Talar dome lesions are usually caused by an injury, such as an ankle sprain. The talus is a bone in the foot that helps form the ankle joint. in 1986. Sixteen patients (16 ankles) with symptomatic osteochondral lesions of the medial talar dome were treated arthroscopically with percutaneous retrograde drilling through the sinus tarsi. Management options are as numerous as the terms used to describe these lesions. 22(7):544-51. . Talar osteochondral lesions tend to involve the medial and lateral corners of the talar dome. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Detached osteochondral lesions and loose bodies secondary to osteochondral lesions of the talar dome usually require fragment removal and debridement of the bone bed. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. The incidence of osteochondral lesions of the talus is increasing because of a greater awareness of this injury following ankle trauma. Mandracchia VJ(1), Buddecke DE Jr, Giesking JL. Foot Ankle Int. Osteochondral lesions of the talar dome are common problems encountered in orthopaedics. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. Small well defined hypointense signal lesion is seen on the T1W images in the medial talar dome at subchondral region. Mild joint effusion is seen at tibio-talar and subtalar joints. The recognition of a traumatic etiology has increased our understanding and management of these disorders. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). 5. Talar dome lesions are usually caused by … We have … 11 Chondral injuries generally occur to either the anterolateral or posteromedial ankle. 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