Medial malleolar osteotomy for the treatment of talar osteochondral lesions: anatomical and morbidity considerations

Leumann, André; Horisberger, Monika; Buettner, Olaf; Mueller-Gerbl, Magdalena; Valderrábano, Víctor

doi:10.1007/s00167-015-3591-y

Cited by 49 publications

(39 citation statements)

References 36 publications

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“…The use of a medial malleolar osteotomy during operative treatment of medially located central and posterior talar osteochondral defects (OCDs) and talar fractures has been well established. 1,2,5-13,15,16,18-23 Osteotomy techniques have evolved since a transverse version was first described by Ray and Coughlin in 1947. 18 Technique permutations notable in the literature since then include oblique, 13,22 crescentic, 23 step-cut, 2,20 modified step-cut, 11 inverted U, 16 and bi-plane chevron 3 osteotomies.…”

Section: Introductionmentioning

confidence: 99%

Rate of Malunion Following Bi-plane Chevron Medial Malleolar Osteotomy

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Rate of Malunion Following Bi-plane Chevron Medial Malleolar Osteotomy

et al. 2016

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“…Ein wesentlicher Nachteil ist, dass trotz aller Maßnahmen, wie Vorbohren der Schraubenlöcher für die spätere Ostsynthese vor der eigentlichen Osteotomie, Einsatz einer zusätz-lichen Schraube parallel zum Gelenksspalt, Durchtrennen des Knochens mit dem Meißel oder auch einer domför-migen Osteotomie, häufig kleine Stufen verbleiben, die als Risikofaktor für eine spätere Arthroseentwicklung angesehen werden. Dies wird umso deutlicher, je häufiger Schnittbildverfahren im weiteren Krankheitsverlauf angefertigt werden [5,18].…”

Section: Operativer Zugang Mit Innenknöchelosteotomieunclassified

Autologe matrixinduzierte Chondrogenese am Sprunggelenk

et al. 2017

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“…An 8- to 10-cm curvilinear medial or lateral incision (Figure 3A,B) was made over the medial or lateral malleolus for medial or lateral OLT, respectively. 29,31 For the medial OLTs (38 cases), a medial malleolus chevron osteotomy was performed 2,3,11,43 approximately 5 to 6 cm above the tip of the medial malleolus (Figures 4 and 5). 43 For the lateral OLTs (3 cases), a chevron osteotomy was performed approximately 3 to 5 cm above the tip of the lateral malleolus and the osteotomy was eventually stabilized with anatomic distal fibula plates as well as cortical and cancellous screws.…”

Section: Methodsmentioning

confidence: 99%

Large Osteochondral Lesions of the Talus Treated With Autologous Bone Graft and Periosteum Transfer

Nikolopoulos¹,

Sergides²,

Safos³

et al. 2019

Foot & Ankle Orthopaedics

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Background: The treatment of large osteochondral lesions of the talus (OLTs) is challenging due to the poor intrinsic reparative capability of the damaged articular cartilage. Autologous transfer of bone and periosteum has been used successfully in the treatment of large defects in animals, and therefore it was believed that this technique might show similar results in humans. The purpose of this study was to assess the outcome of an innovative technique for autologous transplantation of cancellous tibial graft with periosteal transfer in large OLTs. Methods: Forty-one patients (22 females, 19 males), with a mean age of 34.9 years (range, 18-72 years), with a large OLT (>200 mm2) were treated with autologous bone graft and periosteum transfer. OLTs averaging 310 mm2 were identified on a preoperative computed tomography scan. The procedure consisted of malleolar osteotomy, curettage of sclerotic bone, autologous bone graft from the proximal tibia, and transfixion of periosteum over the graft. Outcome measures, including the pain visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Foot & Ankle Disability Index (FADI), were compared between preoperative and 1 and 2 years following surgery. Results: There were significant improvements in VAS pain score from 7.7 before surgery to 1.1 at 1 year after surgery and 0.4 at 2 years or more after surgery. The AOFAS and FADI scores were also significantly improved from 40.3 and 53.3 preoperatively to 95 and 93.2 postoperatively at 1 year and 95 and 93.2 at 2 or more years postoperatively, respectively. Postoperative complications included 2 patients who required removal of medial malleolar osteotomy tension bands due to symptomatic hardware. There were no nonunions or malunions of the osteotomies and no donor site complications. Conclusion: Autologous bone graft and periosteum transfer was an effective treatment for large OLTs leading to significant decreases in pain and improvement in functional scores at more than 2 years after surgery. Level of Evidence: Level IV, retrospective case series.

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Medial malleolar osteotomy for the treatment of talar osteochondral lesions: anatomical and morbidity considerations

Abstract: IV.

Cited by 49 publications

References 36 publications

Rate of Malunion Following Bi-plane Chevron Medial Malleolar Osteotomy

Rate of Malunion Following Bi-plane Chevron Medial Malleolar Osteotomy

Autologe matrixinduzierte Chondrogenese am Sprunggelenk

Large Osteochondral Lesions of the Talus Treated With Autologous Bone Graft and Periosteum Transfer

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