Arthroscopic Bone Marrow Stimulation Techniques for Osteochondral Lesions of the Talus

Yoshimura, Ichiro; Kanazawa, Kazuki; Takeyama, Akinori; Angthong, Chayanin; Ida, Takahiro; Hagio, Tomonobu; Hanada, Hirofumi; Naito, Masatoshi

doi:10.1177/0363546512472979

Cited by 67 publications

(59 citation statements)

References 45 publications

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“…A total of 1303 ankles in 1297 patients were included, with an average age of 34.1 years ranging from 1321 to 7826 years (table 1). The medial side of talus was involved in 924 (71%) of 1302 ankles, while the lateral and the central side in 371 (28%) and 8 (1%) ankles, respectively.…”

Section: Resultsmentioning

confidence: 99%

Talar osteochondral size influences outcome after bone marrow stimulation: a systematic review

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Talar osteochondral size influences outcome after bone marrow stimulation: a systematic review

et al. 2017

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“…Though most of the lesions can be managed successfully under arthroscopy [39]. In case of large lesion localized on the posteromedial talar dome, medial malleolar osteotomy should be indicated [15, 40].…”

Section: Discussionmentioning

confidence: 99%

Osteochondral autograft transplantation with biplanar distal tibial osteotomy for patients with concomitant large osteochondral lesion of the talus and varus ankle malalignment

Zhu

et al. 2017

BMC Musculoskelet Disord

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Background: Osteochondral lesions of the talus (OLTs) are amongst the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (>10 mm), Osteochondral autograft transplantation is usually recommended. This article highlights biplanar distal tibial osteotomy as an approach and management for patients with concomitant large OLTs and varus ankle malalignment. Methods: From January 2012 to July 2014, 13 patients (6 male and 7 female) underwent surgery in our faculty and their average age was 55.4 (ranging from 34 to 69) years old. Oblique medial malleolar osteotomy was performed to expose the talar lesion, followed by an osteochondral autograft transplantation and distal tibial opening-wedge osteotomy. Weight-bearing X-rays were conducted and used for the measurement of radiographic parameters such as the tibial articular surface (TAS) and tibial lateral surface (TLS) angles. Ankle function of the subjects was evaluated according to the American Orthopaedic Foot and Ankle Society-Ankle and Hindfoot score (AOFAS-AH) questionnaires and Visual Analog Scale (VAS). Results: 11 patients completed the follow-up over a mean period of 21.2 months. The average area of talar lesion was 135.9 mm 2 while the average depth was 11.4 mm. The mean time for osseous union was 8.5 weeks. Donor site morbidity was not recorded in any of the cases. The mean AOFAS-AH and VAS improved from 53 to 90 points (p < 0.05) and 6.7 to 1.9 points (p < 0.05) respectively. The mean TAS angle improved from 83.1 to 90.3°(p < 0.05). Conclusions: Biplanar distal tibial osteotomy with the combination of osteochondral autograft transplantation could be used to address patients with concomitant large OLTs and varus ankle malalignment as this technique provides excellent visualization of the talar defect, favorable biomechanical environment for the ankle joint with high rate of good and excellent results.

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“…Although it is an effective and relatively simple technique with low complication rates; location of the lesion (medial vs lateral), patient’s age, deep lesions and medial lesions which are uncovered with medial malleolus are found to have inferior clinical outcomes. 28 Lesion size also seems to be an important parameter for outcome after arthroscopic treatment of OLs but there is confusion whether a cut-off that is associated with poorer outcomes exists or not. Choi et al hypothesised that a defect size may exist at which clinical outcomes become poor and evaluated the results of 125 ankles after microfracture.…”

Section: Hindfoot Abnormalitiesmentioning

confidence: 99%

Treatment of hindfoot and ankle pathologies with posterior arthroscopic techniques

Öğüt

Yontar

2017

EFORT Open Reviews

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The two-portal hindfoot arthroscopy is an effective procedure enabling direct visualisation of posterior ankle pathology with low invasiveness.An important stage of the hindfoot endoscopy is localisation of the flexor hallucis longus (FHL) tendon to protect the neurovascular bundle which is located just medial to it.Posterior ankle impingement syndrome and FHL tenosynovitis are common causes of posterior ankle pain and frequently occur together.Posteriorly localised talar osteochondral lesions, Achilles tendon disorders, osteoarthritis, talar bone cysts and talar fractures are among the other pathologies that can be treated with hindfoot arthroscopy.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160055. Originally published online at www.efortopenreviews.org

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Arthroscopic Bone Marrow Stimulation Techniques for Osteochondral Lesions of the Talus

Abstract: Arthroscopic bone marrow stimulation techniques provided satisfactory clinical outcomes. However, older patients, deep lesions, and medial lesions uncovered with the medial malleolus were associated with inferior clinical outcomes.

Cited by 67 publications

References 45 publications

Talar osteochondral size influences outcome after bone marrow stimulation: a systematic review

Talar osteochondral size influences outcome after bone marrow stimulation: a systematic review

Osteochondral autograft transplantation with biplanar distal tibial osteotomy for patients with concomitant large osteochondral lesion of the talus and varus ankle malalignment

Treatment of hindfoot and ankle pathologies with posterior arthroscopic techniques

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