Incidence of Coexisting Talar and Tibial Osteochondral Lesions Correlates With Patient Age and Lesion Location

Abstract

Background:The incidence of coexisting osteochondral lesions (OCLs) of the tibia and talus has been negatively correlated with successful clinical outcomes, yet these lesions have not been extensively characterized.Purpose:To determine the incidence of coexisting tibial and talar OCLs, assess the morphologic characteristics of these lesions, and evaluate whether these characteristics are predictive of outcome.Study Design:Case series; Level of evidence, 4.Methods:A total of 83 patients who underwent surgery for a talar OCL were evaluated for coexisting OCLs of the distal tibia with preoperative magnetic resonance images. Size, location, containment, International Cartilage Repair Society (ICRS) grade, patient age, and patient sex were analyzed for predictors of coexisting lesions or patient outcome. The talar and tibial surfaces were each divided into 9 zones, with 1 corresponding to the most anteromedial region and proceeding laterally and then posteriorly. The Foot and Ankle Outcome Score (FAOS) was evaluated pre- and postoperatively.Results:Twenty-six patients (31%) had coexisting tibial and talar OCLs, with 9 (35%) identified as kissing lesions. Age correlated with coexisting lesion incidence, as older patients were more likely to have a coexisting tibial OCL (P = .038). More than half of talar OCLs were found in zone 4 (61%), whereas the majority of tibial OCLs were located in zones 2, 4, and 5 (19% each). Patients with coexisting lesions were more likely to have a lateral talar OCL (P = .028), while those without a coexisting tibial lesion were more likely to have a talar OCL in zone 4 (P = .016). There was no difference in FAOS result or lesion size between patients with and without coexisting OCLs, but patients with coexisting lesions were more likely to have an ICRS grade 4 talar OCL (P = .034). For patients with coexisting lesions, kissing lesions were more likely to be located in zone 6 (P = .043). There was no difference in OCL size or containment between kissing and nonkissing coexisting OCLs.Conclusion:The incidence of coexisting talar and tibial OCLs may be more prevalent than what previous reports have suggested, with older patients being more likely to present with this pathology. The location of a talar OCL correlates with the incidence of a coexisting tibial OCL.

Clinical Outcomes of Osteochondral Lesions of the Talus With Large Subchondral Cysts Treated With Osteotomy and Autologous Chondral Grafts: Minimum 2-Year Follow-up and Second-Look Evaluation

“…In this case series, only 5 (26.3%) patients had kissing lesions. Irwin et al 13 reported that 31% (26/83) of their patients had kissing lesions on both the tibial and talar sides. We comparatively analyzed the data of patients with and without kissing lesions.…”

Multipotential stromal cells in the talus and distal tibia in ankle osteoarthritis – Presence, potency and relationships to subchondral bone changes

“…The talus and tibia both had similar levels of typical OA damage, and presented typical hallmarks as found in the hip or knee 37 . OARSI scores between both the talus and tibia were similar, although slightly higher in the talus, akin to that of similar research 56 . Curiously, BA/TA was significantly correlated with OARSI grade in tibia, but not in talus.…”

“…37 OARSI scores between both the talus and tibia were similar, although slightly higher in the talus, akin to that of similar research. 56 Curiously, BA/TA was significantly correlated with OARSI grade in tibia, but not in talus. As the talus had twofold higher BA/TA in grade 3 tissue than tibia ( Figure 4D), this may mean the talus resists increases due to a bone density limit.…”

Characteristics of Osteochondral Lesions of the Talus in Different Age Groups

“…Additional CT is conducted to evaluate the bony lesions more fully, when necessary. With the application of MRI and CT, some studies have found that OLT could occur in people with a larger age range [15,16,22,23]. We need to be cautious about the application of some previous conclusions based on the population with bias.…”