Osteochondral Lesions of the Talus: Localization and Morphologic Data from 424 Patients Using a Novel Anatomical Grid Scheme

Abstract

Our established nine-grid scheme is a useful tool for localizing and characterizing osteochondral talar lesions, which are most frequently located in zone 4 at the medial talar dome, and second most in zone 6 at the lateral talar dome near its equator. Medial talar dome lesions are not only more common but are larger in surface area and in depth than lateral lesions. Posteromedial and anterolateral lesions rarely were found.

Treatment of osteochondral defects of the talus

“…Th e distribution of the OCDs' location in the studied population corresponds to a survey of 428 OCDs in 424 patients. 322 In this survey, 6% of the lesions were located in the anterior third, 81% in the middle third, and 14% in the posterior third, compared with 5%, 70%, and 25%, respectively, in the present study.…”

“…11,259 Most OCDs are localized on the posteromedial (58%) or anterolateral (42%) talar dome (Figure 1), although anteromedial, posterolateral and central lesions also occur. 322,439 In a large magnetic resonance imaging (MRI) survey of 428 affected ankles, 53% of the lesions were localized centromedially and 26% centrolaterally. 322 In 4% to 7% of patients, the occurrence of the defect is bilateral, 49,69,235 suggesting nontraumatic osteochondritis dissecans.…”

“…322,439 In a large magnetic resonance imaging (MRI) survey of 428 affected ankles, 53% of the lesions were localized centromedially and 26% centrolaterally. 322 In 4% to 7% of patients, the occurrence of the defect is bilateral, 49,69,235 suggesting nontraumatic osteochondritis dissecans. Patients with an OCD are frequently 20-to 30-year-old men.…”

“…322 The primary surgical treatment for these lesions is arthroscopic debridement and microfracture. 458 Arthroscopic access to the talar dome is restricted by the tibial plafond.…”

“…For descriptive purposes, the original axial slices of the neutrally positioned ankles were used to divide the location of the OCDs into nine regions according to the anatomic ninegrid scheme described by Raikin et al 322 For further analysis, the anteromedial, anterocentral, and anterolateral locations were combined into the anterior third of the talar dome; the centromedial, centrocentral, and centrolateral into the central third; and the posteromedial, posterocentral, and posterolateral into the posterior third.…”