Osteochondral Lesions of the Talus

Abstract

Osteochondral lesions of the talus (OLTs) are a difficult pathologic entity to treat. They require a strong plan. Lesion size, location, chronicity, and characteristics such as displacement and the presence of subchondral cysts help dictate the appropriate treatment required to achieve a satisfactory result. In general, operative treatment is reserved for patients with displaced OLTs or for patients who have failed nonoperative treatment for 3 to 6 months. Operative treatments can be broken down into cartilage repair, replacement, and regenerative strategies. There are many promising treatment options, and research is needed to elucidate which are superior to minimize the morbidity from OLTs.

Detection of early cartilage degeneration in the tibiotalar joint using 3 T gagCEST imaging: a feasibility study

“…The predefined inclusion criterion for patients was an isolated traumatic OLT lesion as diagnosed in earlier MRI studies. At the time of recruitment, patients were graded according to the Anderson modification of the Berndt and Harty classification and four patients had grade 1 and two patients grade 2b OLT lesions [ 15 , 16 ]. Predefined exclusion criteria for healthy volunteers included all forms of primary or secondary OA of the ankle as well as other bone and joint disorders such as OLT, rheumatoid arthritis, avascular necrosis, gouty arthritis, septic arthritis, Paget disease or osteochondritis dissecans.…”

“…Tibiotalar joint injuries are common [ 15 ]. Osteochondral lesions of the talus (OLT), defined as an injury of the cartilage layer and the underlying subchondral bone, are frequent injuries in active populations that can be seen in up to 73% of all traumatic ankle injuries [ 16 ].…”

Validation of 9-Grid Scheme for Localizing Osteochondral Lesions of the Talus

“…Operative options are extensive and are determined by the OLT stage, size, location, and surgeon preference. 21,23,27,29…”

“…There are effective nonoperative and operative treatments. 10,14,21 However, imaging is essential in determining the location and stage of the lesion. After imaging, an effective treatment plan can be developed for either conservative or operative management.…”

“…Operative options are extensive and are determined by the OLT stage, size, location, and surgeon preference. 21,23,27,29 Traditionally, radiography was used to identify OLTs but fell short in detecting smaller lesions and evaluating the articular cartilage. 1,13,16,25 Mintz et al 15 found that by using magnetic resonance image (MRI) instead of radiography they were able to correctly classify all OLTs with a specificity of 100% using an arthroscopic based scoring system.…”