Osteochondritis Dissecans of the Talus During Childhood and Adolescence

Higuera, José Luis Vázquez; Laguna, Reinaldo; Peral, M Del; Aranda, Ester Badia; Soleto, J

doi:10.1097/01241398-199805000-00011

Cited by 64 publications

(77 citation statements)

References 12 publications

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“…Radiological resolution of OCD was noted in 2 ankles, although all of them showed some degree of healing. All patients had resolution of pain after a mean of 7 (range, [3][4][5][6][7][8][9][10][11][12] months. According to the Higuera classification, 11 clinical outcome was excellent in one and good in 5 ankles, whereas radiological outcome was excellent in 2, good in 2, and fair in 2 ankles.…”

Section: Resultsmentioning

confidence: 99%

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Conservative Treatment for Juvenile Osteochondritis Dissecans of the Talus

Lam

Siow

2012

J Orthop Surg (Hong Kong)

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purpose. To assess outcome of 6 juvenile patients with osteochondritis dissecans (OCD) of the ankle treated conservatively. Methods. Records of 4 males and one female aged 10.8 to 14.1 (mean, 12.3) years who underwent cast immobilisation and/or restriction of physical activities for OCD of the talus (4 on the left and 2 on the right) were reviewed. OCD lesions were graded using the Berndt and Harty classification. Functional outcome was assessed using the ankle-hindfoot score of the American Orthopaedic Foot and Ankle Society. Clinical and radiographic outcomes were assessed according to the Higuera classification. results. The mean follow-up period was 30.5 (range, 11-63) months. The mean ankle-hindfoot score was 90 (range, 86-100). Radiological resolution of OCD was noted in 2 ankles, although all ankles showed some degree of healing. All patients had resolution of pain after a mean of 7 (range, 3-12) months. Surgery 2012;20(2):176-80 outcome was excellent in one and good in 5 ankles, whereas radiological outcome was excellent in 2, good in 2, and fair in 2 ankles. In one patient, the OCD of the right posteromedial talar dome resolved spontaneously. conclusion. Almost all patients achieved good functional outcome after conservative management, regardless of the presence of radiological evidence of healing. Surgery should only be performed if the OCD is unstable. Journal of Orthopaedic

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Section: Resultsmentioning

confidence: 99%

“…For OCD of the talus, both traumatic and ischaemic aetiologies are possible. [9][10][11] Lesions in the anterolateral region are the result of trauma, whereas those in the posteromedial region are due to a non-traumatic or ischaemic origin. Despite this, pathological specimens from the different locations appeared similar.…”

Section: Introductionmentioning

confidence: 99%

Conservative Treatment for Juvenile Osteochondritis Dissecans of the Talus

Lam

Siow

2012

J Orthop Surg (Hong Kong)

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“…U djece kod koje nije dostignuta koštana zrelost operacijsko liječenje nameće se kao osnova zbrinjavanja OLT-a, s obzirom na to da su rezultati nakon provedenog neoperacijskog liječenja kontroverzni (6)(7)(8)(9)(10). Nažalost, malen je broj istraživanja koja su evaluirala učinkovitost metoda operacijskog liječenja ciljano u djece kod koje u trenutku operacijskog zahvata nije bila dostignuta koštana zrelost.…”

Section: Uvodunclassified

“…te Perumal i sur. objavili da je uspjeh neoperacijskog liječenja u njihovim istraži-vanjima postignut u samo devetero (46%), odnosno petero (16%) ispitanika (6)(7)(8)(9). Napose valja istaknuti rezultat istraživanja Reilingha i sur.…”

Section: Rasprava I Zaključciunclassified

Operacijsko liječenje koštanohrskavičnih oštećenja talusa u djece

Bojanić

Jurina²,

Dimnjaković³

et al. 2015

Paediatr Croat

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UVODKoštanohrskavično oštećenje talusa (engl. Osteochondral Lesion of the Talus, u daljnjem tekstu OLT) lokalizirano je oštećenje koje zahvaća zglobnu površinu talusa, a očituje se aseptičkim odvajanjem komadića hrskavice s ili bez dijela pripadajuće subhondralne kosti. Valja istaknuti da je tradicionalni naziv za ovo stanje osteohondritis disekans talusa, no budući da upalna etiologija bolesti nikad nije dokazana, posljednjih se godina u medicinskoj literaturi umjesto tog naziva savjetuje uporabu termina koštanohrskavično ošte-ćenje talusa.Izbor najprikladnijeg načina liječenja OLT-a ponajviše ovisi o odvojenosti koštanohrskavičnog fragmenta od kosti, a na osnovi te odvojenosti zasnivaju se i radiološke klasifi kacije. Kod oštećenja I. i II. stupnja prema Berndt i Hartijevoj klasifi kaciji liječenje se savjetuje započeti neoperacijskim metodama, u prvom redu imobilizacijom te modifi kacijom tjelesnih aktivnosti (1). U slučaju neuspjeha neoperacijskog liječenja te kod oštećenja III. i IV. stupnja preporučuje se provesti operacijsko liječenje (2, 3). Metode operacijskog liječenja su: stimulacija koštane srži (engl. Bone Marrow Stimulation, u daljnjem tesktu BMS), fi ksacija koštanohrs-kavičnog fragmenta, prijenos autogenog koštanohrska-vičnog presatka (engl. Osteochondral Autograft Transfer System), implantacija autolognih hondrocita (engl. Autologous Chondrocyte Implantation) i transplantacija alogenog koštanohrskavičnog presatka (engl. Osteochondral Allograft Transplantation). U današnje vrijeme artroskopski BMS (bušenjem ili tehnikom mikrofraktura) primarna je metoda za operacijsko liječenje OLT-a kod odraslih bolesnika, jer se i nakon višegodišnjeg praćenja dobri ili izvrsni rezultati nala-

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“…4 arthroscopy of the ankle should be performed after all non-operative approaches have failed except in the treatment of displaced osteochondral lesions. 5 The diagnostic indications include pain, swelling, stiffness, instability and locking. an additional indication would be a negative workup in a patient with significant ankle symptoms unresponsive to conservative management.…”

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confidence: 99%

Ankle arthroscopy in children

Vasukutty

Akrawi

Theruvil

et al. 2011

annals

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INTRODUCTION Arthroscopy of the ankle has gained acceptance as a procedure for diagnosing and treating chronic and post-traumatic ankle problems. The senior author's perception is that magnetic resonance imaging (MRI) under-diagnoses anterior soft tissue impingement lesions in children. The purpose of this study was retrospectively to analyse the outcome of ankle arthroscopy in the paediatric age group. PATIENTS AND METHODS Between March 2005 and September 2007, 23 children underwent ankle arthroscopy for post-traumatic pathology. The indications for arthroscopy were failure of non-operative treatment for at least 12 weeks or a grade 3 or 4 osteochondral defect (OCD) on imaging. RESULTS At arthroscopy, OCDs were visualised in 12 cases and impingement lesions were seen in 17 ankles. MRI was performed in 8 of these 12 cases and only 1 suggested the possibility of an impingement lesion. Of the 17 cases of impingement seen on arthroscopy, 12 reported mechanical symptoms preoperatively and 4 were unstable on examination under anaesthetic. Eighteen of the twenty-three patients had complete relief of symptoms at 3 months. Eighteen children who were evaluated at one-year follow up had a mean American Orthopaedic Foot and Ankle Society score of 87. 5 (range: 49-100). CONCLUSIONS Ankle arthroscopy has a successful outcome in paediatric patients and the results are comparable with those reported in adult series. MRI was found to be insensitive for the diagnosis of soft tissue impingement of the ankle.

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Osteochondritis Dissecans of the Talus During Childhood and Adolescence

Cited by 64 publications

References 12 publications

Conservative Treatment for Juvenile Osteochondritis Dissecans of the Talus

Conservative Treatment for Juvenile Osteochondritis Dissecans of the Talus

Operacijsko liječenje koštanohrskavičnih oštećenja talusa u djece

Ankle arthroscopy in children

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