MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

Kerimaa, Pekka; Ojala, Risto; Sinikumpu, Juha‐Jaakko; Hyvönen, Pekka; Korhonen, Jussi; Markkanen, Paula; Tervonen, Osmo; Sequeiros, Roberto Blanco

doi:10.1007/s00330-014-3161-6

Cited by 12 publications

(11 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to the technical demands of accurate drilling [ 93 ] with a previous study reporting 20 percent failure rate [ 94 ], several techniques has been developed in order to improve the accuracy and decrease operative time. MRI guidance has proved to be helpful in a variety of percutaneous musculoskeletal procedures, and Kerimaa et al demonstrated that MRI guidance has 100 percent accuracy, is safe, and technically feasible with no complications for retrograde drilling of OLTs [ 95 ]. In addition, Hoffmann et al reported that an electromagnetic navigation system (ENS) demonstrated higher accuracy and shorter operative time compared to standard fluoroscopic technique [ 93 ].…”

Section: Surgical Strategiesmentioning

confidence: 99%

Management of Osteochondral Lesions of the Talar Dome

Rungprai¹,

Tennant²,

Gentry³

et al. 2017

TOORTHJ

View full text Add to dashboard Cite

Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. While the natural history of the OLTs is not well understood, surgical treatment is often required especially in chronic cases and acute cases with displaced articular fragments. Arthroscopic treatment of the OLTs aims to restore ankle joint function and pain relief by the removal of the chondral or osteochondral fragment, debridement and stabilization of cartilage rim and subchondral bone, and stimulate healing of the bone and damaged cartilage. In patients with a large lesion or after a failure of previous bone marrow stimulation, biologic restoration techniques including the use of particulate juvenile cartilage techniques, autogenous chondrocyte implantation, and osteochondral autograft or allograft transplantation may have role. This article summarizes the contemporary concepts in the clinical evaluation and treatment of OLTs with particular emphasis on surgical strategies.

show abstract

Section: Surgical Strategiesmentioning

confidence: 99%

Management of Osteochondral Lesions of the Talar Dome

Rungprai¹,

Tennant²,

Gentry³

et al. 2017

TOORTHJ

View full text Add to dashboard Cite

show abstract

“…The literature concerning RD was mostly constituted by retrospective case series (17 articles, 81%) [ 6 , 8 , 12 – 26 ], classified as LOE IV. The remaining articles were equally divided into retrospective comparative studies (two articles, 10%) [ 7 , 27 ] and prospective observational studies (two articles, 10%) [ 28 , 29 ], both classified as LOE III (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Despite its wide application, current evidence on the indications for and outcomes of RD in the treatment of osteochondral lesions of the ankle is limited, and a comprehensive review is missing. Moreover, in the last few years there has been some evolution of the original technique [ 6 – 8 ]. Since RD has provided better results compared to anterograde drilling [ 9 ], and the latter is being progressively replaced by microfractures that do not cause heat damage, this review focuses only on RD.…”

Section: Introductionmentioning

confidence: 99%

Retrograde drilling for ankle joint osteochondral lesions: a systematic review

et al. 2023

View full text Add to dashboard Cite

Background Extensive literature exists about the treatment of ankle osteochondral lesions, but there is no specific review of retrograde drilling, despite its common application. Indications for retrograde drilling are still few and are far from clear, and some evolutions of the technique have recently occurred. The aim of this review is to provide an update on actual applications and techniques of retrograde drilling for ankle osteochondral lesions. Methods A systematic review was carried out according to the 2020 PRISMA guidelines. The PubMed and Embase databases were searched in June 2023. The search string focused on studies related to retrograde drilling in the treatment of ankle osteochondral lesions. Results Twenty-one articles for a total of 271 ankles were included in this review. The mean length of the treated lesions was 11.4 mm. Different navigation systems were used, with fluoroscopy the most commonly used. Various adjuvants were employed after drilling, with bone graft the most commonly applied. In most cases, postoperative patient satisfaction and symptom relief were reported, and no complications occurred. Retrograde drilling was found to be suitable for the treatment of subchondral cysts with intact cartilage or small lesions. Some modifications to the original technique may allow surgical indications to be extended to more complex cases. Conclusions Middle-term results of retrograde drilling showed postoperative satisfaction and symptom relief with both original and modified techniques. Additional research is required to investigate the long-term results. Level of evidence: IV. Trial registration: This systematic review was registered on PROSPERO (id number: CRD42022371128).

show abstract

“…On the other hand, there are several reports in which retrograde drilling was used for OCD lesions of the knee and ankle, 14 – 17 and recent studies demonstrated favorable results for retrograde drilling of stable OCD lesions. 18 – 20 Kono et al 21 also reported that the clinical results of retrograde drilling for OCD of the talar dome were superior to those of antegrade transmalleolar drilling. The advantages of retrograde drilling are that it avoids articular surface violation, 22 and it can be combined with retrograde autologous cancellous bone-grafting if it is needed.…”

Section: Discussionmentioning

confidence: 99%

“…In the reports of OCD lesions of the talus, open MRI scanners and navigation systems tend to be used for the retrograde drilling. 14 , 15 , 18 , 22 , 29 However, for drilling the OCD lesion of the femoral condyle, an image intensifier is often used even now. 20 , 30 – 32 The reason for this is that it is thought that a clear lateral view of the femoral condyle is more easily obtained compared to the talus, because the femoral condyle is not surrounded by other bones, unlike the talus.…”

Section: Discussionmentioning

confidence: 99%

Osteochondritis Dissecans Involving the Trochlear Groove Treated With Retrograde Drilling

et al. 2015

View full text Add to dashboard Cite

Osteochondritis dissecans (OCD) occurs frequently in the humeral capitellum of the upper extremity, whereas OCD involving the trochlear groove (trochlear groove OCD) is rarely reported. A standard treatment for trochlear groove OCD has therefore not been determined, although several methods have been tried.The case of a 14-year-old male gymnast with bilateral trochlear groove OCD is presented. Retrograde drilling from the lateral condyle of the humerus was applied for the OCD lesion of the left elbow, since it was larger in size than that in the right elbow and was symptomatic. Conversely, since the right lesion was small and asymptomatic, it was managed conservatively.After treatment, consolidation of the OCD lesions was observed in both elbows. However, the time to healing was shorter in the left elbow treated surgically than in the right elbow managed conservatively.In conclusion, retrograde drilling is a very simple and minimally invasive treatment. This case suggests that retrograde drilling for trochlear groove OCD may be a useful procedure that may accelerate the healing process for OCD lesions.

show abstract

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

Abstract: • MRI serves as a useful guidance method for numerous mini-invasive applications. • Retrograde drilling is a cartilage-sparing alternative in the treatment of osteochondritis dissecans. • MRI guidance seems feasible for treatment of osteochondritis dissecans of the talus.

Cited by 12 publications

References 23 publications

Management of Osteochondral Lesions of the Talar Dome

Management of Osteochondral Lesions of the Talar Dome

Retrograde drilling for ankle joint osteochondral lesions: a systematic review

Osteochondritis Dissecans Involving the Trochlear Groove Treated With Retrograde Drilling

Contact Info

Product

Resources

About