Avascular Necrosis of the Talus Following Subchondroplasty: A Case Report and Review of Literature

Zacharias, Anthony J.; Nazal, Mark R.; Dawson, Ashley N; Aneja, Arun; Srinath, Arjun

doi:10.1177/19386400221108730

Cited by 2 publications

(2 citation statements)

References 48 publications

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“…Многочисленные исследования прямо или косвенно проводят мысль о фатальности изменений при асептическом некрозе таранной кости [8,9]. Признают, что консервативное лечение показано в ряде случаев, но сохранить анатомию таранной кости невозможно, и её коллапс с тяжёлым исходом неизбежен [2,3].…”

Section: дискуссияunclassified

“…[5]. Предложенная операция «субхондральной остеопластики», разработанная для лечения остеонекроза на ранней стадии, не оправдала надежд: есть отзывы, что её применение утяжеляет течение асептического некроза [9]. Приведённый в нашей работе клинический пример демонстрирует возможность излечения пациента консервативным путём на ранних стадиях.…”

Section: дискуссияunclassified

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The possibility of a favourable outcome and reversibility of severe ankle joint damage on the example of a clinical observation

Skuratova,

Gudi,

Luchshev

et al. 2023

Acta biomedica scientifica

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The problem of aseptic talus necrosis consists of the following features: a) manifestation of the disease in the form of acute articular syndrome without typical symptoms; b) inevitable serious consequences in the form of disfiguring deforming arthrosis of the ankle joint, development of gross deformities of the rearfoot, etc., resulting in disability. The lack of methods for monitoring the dynamics of the disease also plays an important role. This is particularly so with such an important issue as the substantiation of stopping immobilization and allowing the load on the foot in order to avoid collapsed talus and subsequent complications. It is believed that treatment started before radiographic changes helps to avoid severe complications, but for a number of reasons patients arrive already at the stage of late severe destructive changes. All of the above explains the high relevance of the problem of treatment of patients with aseptic talus necrosis. The importance of the presented clinical case and the value of this information can be considered several points: its example demonstrates the possibility of early diagnosis of severe talus damage cause by aseptic necrosis; based on objective data, a substantiation was made for allowing the load on the leg with body weight in the complex of rehabilitation measures; the possibility of regression of pathological changes associated with aseptic talus necrosis and the dynamics of the course of aseptic talus necrosis with a favorable outcome were demonstrated, which is confirmed by modern research methods. Thus, the need for magnetic resonance imaging has been confirmed for all referred patients with a clinical picture of local articular syndrome in the ankle joint, the possibility of complete regression of avascular necrosis symptoms in case of conservative treatment at the early stages and the possibility of resolving the load on the leg in the complex of rehabilitation treatment have been demonstrated.

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Section: дискуссияunclassified

The possibility of a favourable outcome and reversibility of severe ankle joint damage on the example of a clinical observation

Skuratova,

Gudi,

Luchshev

et al. 2023

Acta biomedica scientifica

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Complications Following Intraosseous Injections of Calcium Phosphate Bone Cement in Subchondroplasty

Zachariadis,

Leligou,

Kourkoulis

et al. 2024

J Long Term Eff Med Implants

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An alternative approach to the major problem of osteoarthritis that has begun to pique the interest of researchers focuses on the pathology of the subchondral bone, its constant cross-talk with the articular cartilage, and its interaction with the joint. The presence of bone marrow lesions, detectable on MRI scans, has proven to be a cause of pain as well as a predictor of the progression of degenerative changes. Subchondroplasty is a relatively new surgical procedure for the treatment of these lesions, in which injectable calcium phosphate bone cement is infused into the affected area percutaneously, under fluoroscopic guidance. In its use as a synthetic scaffold, calcium phosphate bone cement exhibits considerable osteoconductivity, bioabsorbability, and low toxicity, thus showing great potential for restoring subchondral biomechanical properties through structural remodeling. Although published results appear quite promising, there are certain complications that the surgeon should be aware of. We reviewed the published data regarding complications of the procedure, highlighting possible causes according to these data, and suggesting safety measures. Avascular necrosis of the talus is the most reported concern. Postsurgical pain, infection, and continuous wound drainage due to bone substitute material extravasation to the joint or soft tissue are also mentioned, necessitating further standardization of the procedure. There are no reports of permanent postoperative disability or fatal outcomes.

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Avascular Necrosis of the Talus Following Subchondroplasty: A Case Report and Review of Literature

Cited by 2 publications

References 48 publications

The possibility of a favourable outcome and reversibility of severe ankle joint damage on the example of a clinical observation

The possibility of a favourable outcome and reversibility of severe ankle joint damage on the example of a clinical observation

Complications Following Intraosseous Injections of Calcium Phosphate Bone Cement in Subchondroplasty

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