New classification of osteochondral lesions of the talus in adults

Abstract

Osteochondral lesions (OCL) of the ankle in adults are frequent lesions that mainly affect the cartilage and the subchondral bone, are relatively common, and have varied etiologies. However, in 50% of patients, these lesions may occur concomitantly with chronic instability of the ankle associated with lower limb deformities, acute sprains of the ankle, or fractures. We propose a classification into four types of lesions (traumatic, non-traumatic, with lateral instability of the ankle, and with mechanical axis defects), focusing not only on the diagnosis and treatment of OCL but also on associated injuries, such as instability and/or supramalleolar and hindfoot deformities. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Ankle Instability Update

“…A more recent classification is based on the mechanism: traumatic, nontraumatic, with lateral instability of the ankle, or secondary to instability from associated deformities, but also on the size and depth of the lesions. 59 60 61…”

“…Most authors have agreed that > 50% of the patients with an OCL have a ligamentous injury, associated fracture, or chronic instability of the ankle. [57][58][59][60] Different classification systems from the one described by Berndt and Harty have been developed. A more recent classification is based on the mechanism: traumatic, nontraumatic, with lateral instability of the ankle, or secondary to instability from associated deformities, but also on the size and depth of the lesions.…”

“…A more recent classification is based on the mechanism: traumatic, nontraumatic, with lateral instability of the ankle, or secondary to instability from associated deformities, but also on the size and depth of the lesions. [59][60][61] Impingement CAI and ankle impingement are the result of an inadequate and inappropriate healing process after a ligamentous injury. 10,62 Secondary to repetitive sprains, rupture or microtrauma to the ligaments and capsule, if inadequate scarring occurs, can lead to synovitis, hypertrophy, fibrosis, and metaplasia of the surrounding structures with subsequent soft tissue impingement.…”