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