5. 2015 Sep;21(3):193-7. 2001 Jul. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The recognition of a traumatic etiology has increased our understanding and management of these disorders. 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. 4. Foot Ankle Surg. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. 10. A partial fluid cleft at its posterior margin and a mild subchondral oedema suggests an unstable lesion. Free Online Library: Osteochondral lesions of the talar dome. Osteochondral lesions of the talar dome are a common cause of ankle disability. 73. https://openorthopaedicsjournal.com/VOLUME/11/PAGE/743/FULLTEXT Detached osteochondral lesions and loose bodies secondary to osteochondral lesions of the talar dome usually require fragment removal and debridement of the bone bed. Talar dome lesions are usually caused by … Kouvalchouk et al. by "Bulletin of the NYU Hospital for Joint Diseases"; Health, general Anklebone Bone diseases Care and treatment Cartilage Injuries Osteochondritis Osteochondrosis Talus (Anklebone) An osteochondral injury to the talar dome produces pain at the ankle and you will … Mandracchia VJ(1), Buddecke DE Jr, Giesking JL. 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. Osteochondral lesion of the talar dome Share | Definition. Talar osteochondral lesions tend to involve the medial and lateral corners of the talar dome. 3. Etiology of these lesions is debated but trauma seems the most supported etiology. (A) Unstable medial talar dome osteochondral lesion of the talus. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. 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. Author information: (1)Broadlawns Medical Center, Des Moines, Iowa, USA. 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 term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. “Osteo” means bone and “chondral” refers to cartilage. Anderson IF, Crichton KJ, Grattan-Smith T. Osteochondral fractures of the dome of the talus. “Osteo” means bone and “chondral” refers to cartilage. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). Hangody L: The mosaicplasty technique for osteochondral lesions of the talus. Sixteen patients (16 ankles) with symptomatic osteochondral lesions of the medial talar dome were treated arthroscopically with percutaneous retrograde drilling through the sinus tarsi. Medial lesions are more common than the lateral ones and typically located at the posteromedial talar dome, with a typicall deep - cupshaped figure. Talar dome lesions are usually caused by an injury, such as an ankle sprain. 11 Chondral injuries generally occur to either the anterolateral or posteromedial ankle. 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. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. Initially, OLT was described and classified as ‘transchondral fractures of the talus’ by Berndt and Harty in 1959 (1) . in 1986. The talus is a bone in the foot that helps form the ankle joint. FIGURE 71-1 Osteochondral lesion of the talus. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Radiographs showed a suspicious area on the lateral talar dome. 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. 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). Conservative management, including weight-bearing restrictions, physical therapy, and supportive measures, often is first-line treatment. Patients tend to present… Nelson SC, Haycock DM: Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. Foot Ankle Clinics 8(2): 259-273, 2003. A comprehensive review with retrospective study. Kelberine F, Frank A. Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases. Medial lesions tend to be deeper and cup shaped. Osteochondral lesion (OCL) of the talar dome is rare in children. “Osteo” means bone and “chondral” refers to cartilage. Canale ST, Belding RH: Osteochondral lesions of the talus. Approximately 10% of osteochondral talar dome lesions … Management options are as numerous as the terms used to describe these lesions. “Osteo” means bone and “chondral” refers to cartilage. 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. 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. 2012; 28(12):1902-1907. Talar dome lesions are usually caused by … A medial talar dome injury is seen on a mortise x-ray view. ( 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. The use of various Outcome of arthroscopic debridement and microfracture as the primary treatment for osteochondral lesions of the talar dome. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). JAPMA 95(1): 91-96, 2005. We have … 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. 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. 9. onnenwerth MP, Roukis TS. All … OLTs typically are preceded by a traumatic event and generally result in vascular damage to the subchondral bone. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. Osteochondral lesions of the talar dome. Injuries to the talar dome should be suspected when an athlete presents with chronic ankle pain following an injury to the ankle. The incidence is similar, but lateral talar dome injuries … 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. It is often associated with a traumatic injury such as a severe ankle sprain. Background: Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Mild joint effusion is seen at tibio-talar and subtalar joints. Arthroscopy. 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. 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. Epub 2014 Dec 11. Small well defined hypointense signal lesion is seen on the T1W images in the medial talar dome at subchondral region. The incidence of osteochondral lesions of the talus is increasing because of a greater awareness of this injury following ankle trauma. (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. 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. 22(7):544-51. . A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). … Osteochondral lesions of the talar dome are common problems encountered in orthopaedics. Terminology. JBJS 62(1): 97-102, 1980. (B) Lesion debrided to stable margins. Arthroscopy. Talar dome lesions are most common, while talar head lesions are relatively rare. Particulated juvenile cartilage allograft transplantation. 2. 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. 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. Foot Ankle Int. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Adjacent subtle marrow edema seen in the medial aspect of talus bone. 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