Current Concepts: Treatment of Osteochondral Ankle Defects

Zengerink, Maartje; Szerb, Imre; Hangody, László; Dopirak, Ryan M.; Ferkel, Richard D.; Dijk, C. Niek van

doi:10.1016/j.fcl.2006.03.008

Cited by 145 publications

(118 citation statements)

References 48 publications

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“…An advantage is that lesions can be treated ''around the corner'', because the end of the awl is curved [12]. This makes constant distraction unnecessary, which may lead to fewer complications [4].…”

Section: Discussionmentioning

confidence: 99%

Potential pitfall in the microfracturing technique during the arthroscopic treatment of an osteochondral lesion

Bergen

Leeuw

Dijk

2008

Knee Surg Sports Traumatol Arthrosc

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Debridement and bone marrow stimulation of the subchondral bone is currently considered to be the primary surgical treatment of most osteochondral lesions of the talus. Different methods of bone marrow stimulation are used, including drilling, abrasion, and microfracturing. The latter has gained recent popularity. In this technical note we describe a potential pitfall in the microfracturing technique. The microfracture awl can easily create small bony particles on retrieval of the probe that may stay behind in the joint. It is emphasized that the joint should be carefully inspected and flushed at the end of each procedure, in order to prevent leaving behind any loose bony particles.

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Section: Discussionmentioning

confidence: 99%

Potential pitfall in the microfracturing technique during the arthroscopic treatment of an osteochondral lesion

Bergen

Leeuw

Dijk

2008

Knee Surg Sports Traumatol Arthrosc

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“…440 CT is useful in determining the size, location, shape and degree of displacement of osteochondral fragments, and is therefore valuable in preoperative planning. 160,370,440,457 MRI offers the advantage of visualizing bone bruises, articular cartilage damage, and other soft tissue insults, but signal patterns in the talus may overestimate the severity of the bone injury. 303 …”

Section: Imagingmentioning

confidence: 99%

“…206 The talar dome is the secondly most common location in the human body; most occur in the knee. 457 An OCD is often not recognized and therefore not adequately treated. The nonrecognition is mainly due to the fact that the lesion produces symptoms of previous trauma, and it cannot always be identified on plain radiographs.…”

Section: Introductionmentioning

confidence: 99%

Treatment of osteochondral defects of the talus

Bergen

Leeuw

Dijk

2008

Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Mo

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“…However, this technique inevitably creates iatrogenic lesions to intact cartilage on the tibial side of the malleolus, and theoretically it creates new cartilage lesions without sufficient healing capacity. 2,5,7 To our knowledge, no cases concerning the presence of a kissing lesion after arthroscopically assisted transmalleolar drilling have been reported. We report on a patient that presented with this kind of lesion.…”

mentioning

confidence: 99%

“…4 Therefore, most treatment schedules prefer bone marrow-stimulating techniques (especially drilling) as the first choice surgical procedure. 5,6 Despite recent innovations, certain areas, such as the posteromedial talar dome lesions, are still difficult to manage arthroscopically. The goal of the technique is to enter the defect with a Kirschner wire or drill in a perpendicular fashion.…”

mentioning

confidence: 99%

Iatrogenic Osteochondral Kissing Lesion After Transmalleolar Drilling of the Talar Dome

D’Hooghe

Deschamps

Matricali

2009

Journal of the American Podiatric Medical Association

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Ankle injuries can lead to early osteoarthrosis when diagnosis is delayed. The clinical presentation of an osteochondral lesion of the talar dome is often difficult to diagnose in the initial setup of an ankle sprain or fracture. Once the lesion is adequately imaged and staged, open or arthroscopic treatment can be initiated. We discuss the arthroscopic treatment of a posteromedial talar dome lesion in this case report. Transmalleolar drilling was performed to treat an osteochondral lesion of the talar dome in a 24-year-old female. Her ankle evolved toward a severe clinical and radiologic condition in which a combined talar and tibial (kissing) lesion was seen during her follow-up. Therefore, we recommend the use of retrograde drilling or arthroscopic microfracture with minimal iatrogenic risk, instead of transmalleolar drilling, as the treatment of choice in these specific osteochondral lesion of the talar dome cases. (J Am Podiatr Med Assoc 99(1): 54–57, 2009)

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Current Concepts: Treatment of Osteochondral Ankle Defects

Cited by 145 publications

References 48 publications

Potential pitfall in the microfracturing technique during the arthroscopic treatment of an osteochondral lesion

Potential pitfall in the microfracturing technique during the arthroscopic treatment of an osteochondral lesion

Treatment of osteochondral defects of the talus

Iatrogenic Osteochondral Kissing Lesion After Transmalleolar Drilling of the Talar Dome

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