Critical three-dimensional factors affecting outcome in osteochondral lesion of the talus

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

doi:10.1007/s00167-013-2364-8

Cited by 33 publications

(31 citation statements)

References 40 publications

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“…Overall, 95.5% of the studies included were level IV[ 4 , 7 , 17 , 18 , 20 , 22 , 25 - 29 , 31 ] or level III[ 3 , 5 , 16 , 19 , 21 , 23 , 30 , 32 ]. No level I studies were included in the current review.…”

Section: Resultsmentioning

confidence: 99%

“…With regard to Part B, “Outcome criteria” had significantly higher scores compared with the others ( P < 0.05). Of the 22 included studies, 14 studies (63.6%) were of fair quality[ 3 - 5 , 13 , 19 , 20 , 23 - 25 , 27 , 28 , 30 - 32 ], 7 (31.7%) of poor quality[ 7 , 16 - 18 , 22 , 26 , 28 ] and only 1 (4.5%) study[ 21 ].…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of bone marrow stimulation for osteochondral lesion of talus - evaluation for level and quality of clinical studies

Yasui¹,

Ramponi²,

Seow³

et al. 2017

WJO

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AIMTo clarify the quality of the studies indicating lesion size and/or containment as prognostic indicators of bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLT).METHODSTwo reviewers searched the PubMed/MEDLINE and EMBASE databases using specific terms on March 2015 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. Predetermined variables were extracted for all the included studies. Level of evidence (LOE) was determined using previously published criteria by the Journal of Bone and Joint Surgery and methodological quality of evidence (MQOE) was evaluated using the Modified Coleman Methodology Score.RESULTSThis review included 22 studies. Overall, 21 of the 22 (95.5%) included studies were level IV or level III evidences. The remaining study was a level II evidence. MQOE analysis revealed 14 of the 22 (63.6%) included studies having fair quality, 7 (31.8%) studies having poor quality and only 1 study having excellent quality.CONCLUSIONThe evidence supporting the use of lesion size and containment as prognostic indicators of BMS for OLTs has been shown to be of low quality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Systematic review of bone marrow stimulation for osteochondral lesion of talus - evaluation for level and quality of clinical studies

Yasui¹,

Ramponi²,

Seow³

et al. 2017

WJO

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“…The ECD competes with other techniques of bone marrow stimulation. Lesion diameter, depth, and patient age have been found to be prognostic factors in bone marrow stimulation techniques [ 14 – 16 ]. Abrasive treatment and bone marrow stimulation in OLT larger than 100 mm 2 often lead to persistent pain and the need for follow-up surgery with restoration of the medial talar dome contour by osteochondral transplantation or cancellous bone grafting.…”

Section: Discussionmentioning

confidence: 99%

“…Angthong et al postulate that defect depth is another prognostic factor determining clinical outcome. In their study, in which they treated 50 patients by debridement, drilling and/or micro-fracturing, they observed unsatisfactory results in lesions with a depth of more than 7.8 mm [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Operative Technique and Clinical Outcome in Endoscopic Core Decompression of Osteochondral Lesions of the Talus: A Pilot Study

et al. 2016

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BackgroundRevitalizing the necrotic subchondral bone and preserving the intact cartilage layer by retrograde drilling is the preferred option for treatment of undetached osteochondral lesions of the talus (OLT). We assessed the effectiveness of Endoscopic Core Decompression (ECD) in treatment of OLT.Material/MethodsSeven patients with an undetached OLT of the medial talar dome underwent surgical treatment using an arthroscopically-guided transtalar drill meatus for core decompression of the lesion. Under endoscopic visualization the OLT was completely debrided while preserving the cartilage layer covering the defect. The drill tunnel and debrided OLT were filled using an injectable bone graft substitute. Various clinical scores, radiographic imaging, and MRI were evaluated after a mean follow-up of 24.1 months.ResultsThe American Orthopedic Foot and Ankle Society Score significantly improved from 71.0±2.4 to 90.3±5.9, and the Foot and Ankle Disability Index improved from 71.8±11.1 to 91.7±4.8. Radiographically, we observed good bone remodelling of the medial talar dome contour within 3 months. In MRI, an alteration of the bony signal of the drill tunnel and the excised OLT remained for more than 12 months.ConclusionsFirst follow-up results for the surgical technique described in this study are highly promising for treatment of undetached stable OLT grade II or transitional stage II–III according to the Pritsch classification. Even lesions larger than 150 mm2 showed good clinical scores, with full restoration of the medial talar dome contour in radiographic imaging.

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“…Knowledge and technology in the field of foot and ankle surgery have progressed rapidly in recent decades. This is evident by the advances in total ankle replacement surgery [1], replacement surgery using total artificial tali [2], and arthroscopic surgery [3]. Such substantial technological progress in foot and ankle surgery has been made possible by the knowledge gained from morphological research in technologies such as computed tomography (CT) [4], threedimensional (3D) printing technology [5], and computer-aided design programs, which transform CT images into 3D images [2].…”

Section: Introductionmentioning

confidence: 99%

Morphometric geometric differences between right and left human tali: A cadaveric study of fluctuating asymmetry via systematic measurement and three-dimensional scanning

et al. 2020

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Background Little is known about differences in the size and morphology of the right and left human tali. The present study demonstrates differences between right and left talar morphometric geometric profiles as fluctuating asymmetry in matched pairs of cadaveric specimens. Methods In total, 24 tali were collected in this study. All eligible tali were systematically measured with a Vernier caliper and three-dimensional laser scanner, which provided data for further analysis regarding the talar morphometric geometric profiles. Data were calculated to demonstrate differences between the right and left talar profiles using a matched-pair method, including the general size of the talus. Results The average talar length was 53.5 mm, the average talar dome height was 31.2 mm, and the average talar body width was 41.3 mm. The average anterior trochlear width, middle trochlear width, posterior trochlear width, and trochlear length were 31.8, 31.2, 28.3, and 30.7 mm, respectively. Eleven matched pairs of intact tali were eligible for the matched-pair study. Paired t-tests showed significant differences in the talar dome height (P = 0.019), middle trochlear width (P = 0.027), and posterior trochlear width (P = 0.016) between the right

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Critical three-dimensional factors affecting outcome in osteochondral lesion of the talus

Cited by 33 publications

References 40 publications

Systematic review of bone marrow stimulation for osteochondral lesion of talus - evaluation for level and quality of clinical studies

Systematic review of bone marrow stimulation for osteochondral lesion of talus - evaluation for level and quality of clinical studies

Operative Technique and Clinical Outcome in Endoscopic Core Decompression of Osteochondral Lesions of the Talus: A Pilot Study

Morphometric geometric differences between right and left human tali: A cadaveric study of fluctuating asymmetry via systematic measurement and three-dimensional scanning

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