17 Osteochondral Lesions of the Talus MARK E. EASLEY, STEVEN D. SIDES, AND ALISON P. TOTH Treatment of symptomatic focal talar osteochondral defects has undergone a dramatic evolution over the past decade. Bale RJ, Hoser C, Rosenberger R, Rieger M, Benedetto KP, Fink C. Osteochondral lesions of the talus: computer-assisted retrograde drilling—feasibility and accuracy in initial experiences. An osteochondral injury to the talar dome produces pain at the ankle and you will … Clinical management of these lesions is based on whether or not the fragments are attached. Foot Ankle Int 1999; 20:474-480. Two patients (a 16-year-old boy) had two recent osteochondral fractures, anterior and superior lateral, with a free fragment detached in the joint. Two patients (a 16-year-old boy) had two recent osteochondral fractures, a… Clin Orthop Relat Res. Talar dome chondral and osteochondral lesions are a common cause of ankle pain and subjective instability. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Crossref, Medline, Google Scholar; 12. “Osteo” means bone and “chondral” refers to cartilage. These sequences were performed, and their ability to distinguish the osteo-chondral lesions from normal bone, carti- Few studies have evaluated the incidence of talar dome lesions and injuries to the peroneal tendons occurring concomitantly. … The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. The talus is a bone in the foot that helps form the ankle joint. of talar osteochondral lesions. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. The lesions were treated with simple ablation of the loose body. A similar pattern was subsequently described at the talar dome in 1922 by Kappis and colleagues.3, 4 The etiology of these lesions remains controversial today with numerous proposed biomechanical explanations and causes in the orthopaedic, pediatric, radiology… Ankle Traction During MRI of Talar Dome Osteochondral Lesions. Talar dome lesions are usually caused by an injury, such as an ankle sprain. 2 of 7 Posadzy et al: Staging of Osteochondral Lesions of the Talus Figure 1: Location of the OCL according to the mechanism of trauma. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The most common sites are the posteromedial (53%) ( Fig. 20, No. RSNA, 2009 Supplemental material: ... Radiology: Volume 252: ... dral lesion of the medial talar dome were imaged. Medial lesions tend to be deeper and cup shaped. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). Yvars MF. Radiology. A talar dome lesion can be difficult to diagnose because the precise site of the pain can be hard to pinpoint. Patients tend to present… Treatment of Osteochondral Lesions of the Medial Talar Dome with Osteochondral Autograft Transplantation Operative Techniques in Orthopaedics, Vol. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Purpose: The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. Retrograde drilling of osteochondral lesions of the medial talar dome. To diagnose this injury, the surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking or limited motion within that joint. Foot Ankle Int 1999; 20( 8): 474– 480. Diagnosis. It is relatively prevalent and are an important cause of ankle morbidity. A partial fluid cleft at its posterior margin and a mild subchondral oedema suggests an unstable lesion. Art. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). [1] Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Osteochondral lesions may also involve the talar dome, most frequently the medial aspect. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. Talar dome lesions are usually caused by … 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. A medial talar dome injury is seen on a mortise x-ray view. They may also be called osteochondritis dessicans or osteochondral fractures. Subtle transchondral fractures of the talar dome: a radiological perspective. 1977 Sep; 124 (3):667–673. Management of symptomatic osteochondral lesions of the talus (OLT) is challenging given the poor healing potential of articular cartilage. Many of these lesions are first diagnosed by plain film. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. Most OCD of the talar dome (8a) treated non-operatively improve or show no change on MRI at an average of 13.7 months, and marrow edema and subchondral cysts are not reliable indicators of progression. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. These sequences were performed, and their ability to distinguish the osteochondral lesions from normal bone, cartilage, and surrounding soft tissue was assessed. Osteochondral lesion of the talus in children: Are there MRI ... Keywords Ankle .Children .MRI .OCD .OLT .Osteochondritisdissecans .Osteochondrallesion .Talar dome Introduction Osteochondritis dissecans (OCD) ... 2 Department of Radiology, Children ’s Hospital … Talar Dome. It is often associated with a traumatic injury such as a severe ankle sprain. We studied the value of MR imaging in determining the stability of the osteochondral fragments. (B) Lesion debrided to stable margins. Crossref, Medline, Google Scholar; 7 Kumai T, Takakura Y, Higashiyama I, Tamai S. Arthroscopic drilling for the treatment of osteochondral lesions of the talus. 1, pp. Smith GR, Winquist RA, Allan NK, Northrop CH. J Bone Joint Surg Am 1999; 81:1229-1235. Furthermore, the ankle joints of five volunteers without osteochondral lesions of the medial talar dome and one volunteer with an osteochondral lesion of the medial talar dome were imaged. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. Talar dome lesions are usually caused by … (A) Unstable medial talar dome osteochondral lesion of the talus. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma; Epidemiology . There is an osteochondral fracture of the posterolateral part of the talar dome; the fractured fragment is detached and flipped upside down, so that the articular cartilage is visible at its inferior surface. “Osteo” means bone and “chondral” refers to cartilage. Particulated juvenile cartilage allograft transplantation. 1976 Jan-Feb;(114):185–191. Lesions in the medial third of the talar dome were significantly larger in surface area involvement and deeper than those at the lateral talar dome. Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. “Osteo” means bone and “chondral” refers to cartilage. Lee RKL(1), Griffith JF(1), Law EKC(1), Ng AWH(1), Yeung DKW(1). Nine osteochondral lesions of the talar dome were treated arthroscopically. METHODS: Thirty-three patients (mean age, 35.1 years; body mass index, 26.8) with osteochondral lesions of the medial talar dome were retrospectively evaluated after open AMIC repair at a mean follow-up of 4.7 years (range, 2.3-8.0 years). Retrograde drilling of osteochondral lesions of the medial talar dome. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Osteochondral fractures of the dome of the talus. 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. incidence 69% of ankle fractures; 70% of ankle sprains; 10% are bilateral 3 Autogenous bone grafting for the treatment of talar dome lesions 1 ) and anterolateral (46%) talar dome ( 1 ). If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. Materials and method: This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March … Author information: (1)1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Rm 2A061, 2/F, New Extension Block, Prince of Wales Hospital, 30-32 Ngan Shing St, Shatin, New Territories, Hong Kong, SAR. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. There is also reactive bone marrow edema of the distal tibia and the talus. Medline, Google Scholar Nine osteochondral lesions of the talar dome were treated arthroscopically. The purpose of our research was to evaluate the incidence of osteochondral lesions of the talus (OLT) with peroneal tendon pathologic features according to the magnetic resonance imaging (MRI) findings. OCDs of the talus represent damage to the articular surface of the talar dome in the ankle joint. Talar osteochondral lesion of the pain can be talar dome osteochondral lesion radiology to pinpoint reactive bone marrow edema of the talar dome imaged. In determining the stability of the ankle joint lesions tend to be deeper and shaped! 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