A novel metal inlay implant (Hemicap, Arthrosurface, Frankin, MA) technique was developed in 2007 for the lesion on medial side of the talus. Foot Ankle Int 2011; 32(11): 1045-51. Introduction. Foot Ankle Int 2002; 23(8): 693-8. Contribute and/or solicit Guest Edited thematic issues to the journal in a hot area (at least one thematic issue every two years). The two theories found some harmony with the 1966 conclusion by Campbell and Ranawat the osteochondritis dissecans creates ischemic pathologic fractures of bone . DeLee et al. Moreover, Sammarco et al. Mintz DN, Tashjian GS, Connell DA, Deland JT, O' Malley M, Potter HG. “Osteo” means bone and “chondral” refers to cartilage. Choi WJ, Choi GW, Kim JS, Lee JW. Osteochondral autografts for osteochondritis dissecans of the talus. Foot Ankle Int 2001; 22(5): 385-91. However, the current literature does not allow firm evidence-based recommendations concerning the treatment to be established [35-37]. Foot Ankle Int 2014; 35(10): 1087-94. studied 12 patients with mean follow-up of 63 months, reporting that the improvement of AOFAS score was 43.5 to 88.5 and Hanover score was improved from 40.4 to 85.5 at final post-operative visit . Professor Malemud is on the editorial board of several rheumatology, immunology and musculoskeletal journals and is Editor-in-Chief of the Journal of Clinical and Cellular Immunology and Global Vaccines and Immunology. The purpose of conservative treatment is to decrease or unload the injured cartilage, so bone edema can be resolved and necrosis can be prevented. ", "It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. reported the mid-term results with an average follow-up of 48 months after performing fresh osteochondral allograft. Mitchell ME, Giza E, Sullivan MR. Cartilage transplantation techniques for talar cartilage lesions. They require a strong plan. The indication for the osteochondral allograft transplantation includes large and deep osteochondral defects and failure of previous surgical treatment [129, 131, 132]. performed a prospectively randomized controlled trial (Level II study) with 33 ankles in 32 patients, showing no difference between chondroplasty, microfracture, and OAT technique with regard to Ankle-Hindfoot Scale (AHS) and the Subjective Assessment Numeric Evaluation (SANE) rating in patients with OLT . Terminology. Osteochondral lesions of the talus (OLTs) have various names and presentations. Treatment of talar osteochondral lesions using local osteochondral graft. ", "The widest possible diffusion of information is critical for the advancement of science. Draper SD, Fallat LM. (B) Lesion debrided to stable margins. “Osteo” means bone and “chondral” refers to cartilage. They usually relate the pain to a single injury, recurrent sprains, or feelings of chronic instability . [eng.]. Multiple additional classification systems have been proposed based on MRI. Arthroscopic treatment of osteochondral lesions of the talus. The most common cause of a talar lesion is due to an ankle sprain and up to 50 percent of sprains involve some injury to the cartilage. FIGURE 3 Ferkel and Sgaglione’s CT classification of osteochondral lesions of the talus. Ray RB, Coughlin EJ Jr. Osteochondritis dissecans of the talus. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. 4). 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. Complete list of publications and h-index. Am J Sports Med 2013; 41(1): 126-33. Lui TH. At the time they referred to it as “… an arbitrary classification which was developed to aid understanding of the etiological mechanism of the fracture and to help determine the appropriate treatment . Osteochondral allograft transplantation is an effective procedure for the treatment of large OLTs using mature hyaline cartilage allograft which provides an anatomically articulating surface and prevents ankle joint arthrosis by avoiding excessive weight on the remaining portion of the talus [128, 129]. If conservative treatment fails, surgical treatment is indicated. Osteochondritis dissecans: the question of etiology. suggested internal fixation of the lesion if it is larger than one third of the size of talar dome  while Stone et al. Am J Knee Surg 1998; 11(1): 42-6. Osteochondral fractures of the talus (Osteochondritis Dissecans). This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Prospective study on diagnostic strategies in osteochondral lesions of the talus. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor. Tertiary osteochondral defect of the talus treated by a novel contoured metal implant. Osteochondral lesions of the talus in a sports medicine clinic. Lesions of the trochlea tali. Adams SB Jr, Viens NA, Easley ME, Stinnett SS, Nunley JA II. Nelson SC, Haycock DM. studied 9 patients with an average of 23 months follow-up with mean improvement of the Mazur ankle score of 23 points with minor morbidity at the donor site . Orthop Trans 1990; 14: 172-8. 1) and determined only by plain radiographs. If the size of the lesion is not larger than 15 mm or deeper than 7 mm, bone marrow stimulation technique including excision, curettage, and drilling or microfracture can be performed. Osteochondral lesion of the talus: prognostic factors affecting the clinical outcome after arthroscopic marrow stimulation technique. The vast majority of lesions were the in the middle (80%), with relatively fewer anterior or posterior (6% and 14%, respectively) . Indication for this technique is large lesion or revision of the large lesion that does not respond to bone marrow stimulation techniques [85, 87]. Kreuz PC, Steinwachs M, Erggelet C, Lahm A, Henle P, Niemeyer P. Mosaicplasty with autogenous talar autograft for osteochondral lesions of the talus after failed primary arthroscopic management: a prospective study with a 4-year follow-up. Arthroscopy techniques 2014; 3(4): e533-7. This technique is a reconstructive bone grafting technique that use one or more cylindrical osteochondral grafts from the less weightbearing periphery of the ipsilateral knee [115, 116] or ipsilateral talus  with transplantation into the prepared defect site on the talus . Due to the technical demands of accurate drilling  with a previous study reporting 20 percent failure rate , several techniques has been developed in order to improve the accuracy and decrease operative time. Osteochondral lesion of the talar dome Share | Definition. Epub 2014/09/30. (Table 2). OLTs present a treatment challenge due to the innate inability of cartilage to heal. J Bone Joint Surg Br 1982; 64(4): 494-7. Articular cartilage has poor regenerative capacity, and the osseous blood supply to the talus is tenuous. An anterolateral lesion may be approached without an osteotomy, while a posteromedial lesion requires a medial malleolus osteotomy. In addition, Scranton et al. Stone JW. in 1986 and found to have no significant correlation with the preoperative radiographic Berndt and Hardy stage . Lundeen RO, Stienstra JJ. The cartilage cell can be harvested from the detached cartilage, the margins of the lesion, or from the knee joint . 1995. ", "There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Sitler DF, Amendola A, Bailey CS, Thain LM, Spouge A. Posterior ankle arthroscopy: an anatomic study. Anders S, Lechler P, Rackl W, Grifka J, Schaumburger J. Fluoroscopy-guided retrograde core drilling and cancellous bone grafting in osteochondral defects of the talus. Conservative management, including weight-bearing restrictions, physical therapy, and supportive measures, often is first-line treatment. 2003;19(4):353-9. [eng.]. J Bone Joint Surg Am 2013; 95(11): 1045-54. Foot Ankle Int. Autologous chondrocyte implantation (ACI) involves the use of cultured chondrocytes with a periosteal patch. Most osteochondral lesions of the talus are located in the medial or lateral portion of the talar dome, and rarely in the central portion , , , , , , .When the lesion is located in the central area, the operative approaches reported in the literature are not practical. Osteochondral lesions of the talus: a radiologic and surgical comparison. J Bone Joint Surg Am 2004; 86-A(6): 1336. Talar dome injuries are often missed on initial examination of a routine ankle sprain, only to be diagnosed weeks after the injury. Treatment of deep articular talus lesions by matrix associated autologous chondrocyte implantationresults at five years. Osteochondral lesions of the talus. Retrograde drilling (RD) has been used in patients who have intact cartilage as it can avoid injury to the undetached talar cartilage as a non-transarticular procedure. O’ Farrell et al. Various treatment strategies have been described for OLT, including conservative treatment (rest/restriction of activities and immobilization in the cast) and operative treatment (excision, excision with curettage, excision with curette and drilling/microfracture, excision with curette and autogenous grafting, excision with curetted and particulated juvenile cartilage, retrograde drilling, autogenous chondrocyte implantation, osteochondral autograft transplantation, and osteochondral allograft transplantation) [32-34]. Aofas scores from 70.2 pre-operatively to 89.5 at 36 months post-operatively [ 105, 113 ] difficult to and. Journal is seeking energetic and qualified researchers to join its editorial board team as editorial board Members or reviewers a! Predominant CT staging system for retrograde drilling of osteochondral lesions of the loose bone and “ chondral ” to. Abstract presented at the Annual Meeting of the talus typically present with more symptoms... 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