Osteochondritis dissecans of the talus

Abstract

Osteochondritis dissecans (OCD) is an acquired idiopathic lesion of subchondral bone that can produce delamination and sequestration with or without articular cartilage involvement and instability. The cause of OCD is still debated: the most recognized etiology is the occurrence of repetitive micro-traumas associated with vascular impairment, causing progressive ankle pain and dysfunction in skeletally immature and young adult patients. Ankle OCD is classically located in the medial part of the talus, while lateral and posterior involvement is less frequent. Diagnosis of OCD, based on MRI findings, is quite straightforward; MRI examination can also be very useful for dating the defect and obtaining information about the associated bone bruise. Osteochondritis dissecans, if not recognized and treated appropriately, may lead to secondary osteoarthritis with pain and functional limitation. Surgical treatment is mandatory especially in young patients with unstable cartilage fragments. There are various surgical options: fixation, microfracture, or substitution using autologous chondrocyte implantation techniques.

Radiographic and Computed Tomographic Anatomy of the Donkey Carpus

“…The CT without contrast gave precise information about the location and extent of the lesion, but it did not enable the assessment of the integrity of the cartilage. 21 The fractures reported in the carpal joint in the medial aspect of the distal extremity of the radius, especially at the radial cochlea, after the CT scan had the same description mentioned by others authors; 22,23 these fractures were not detected in any of the radiographic views used in the present study. The site of the bone sclerosis at the carpal joint detected at the radial facet of the third carpal bone was characterized by high radiopacity and loss of the trabecular pattern, with degenerative changes and bone changes at its dorsomedial surface; these findings are in line with findings previously recorded in the study by Bergman and Saunders.…”

Partial Hemiresurfacing of Osteochondral Defects of the Talus? Surgical Technique and Preliminary Report from Four Patients

“…However, talar osteochondral lesions are often associated with traumatic events such as ankle sprains [1 -6]. The most common localization is the medial talar dome, and the morphology is typically cup-shaped with subchondral cystic formation [7,8]. Nonoperative treatment, particularly in pediatric patients, represents a valid treatment option [9 -11].…”

Patofisiologi dan Tatalaksana Osteochondral Lesion of the Talus

“…Angka kejadian OLT paling sering terjadi pada dekade kedua kehidupan, meskipun manifestasi klinisnya dapat muncul di usia yang lebih tua. 2 Talus terletak di lokasi yang strategis, yakni pada kompleks sendi pergelangan kaki. Talus memiliki peran penting dalam distribusi gaya tekanan berat badan.…”

“…Pertama, 60% dari tulang talus tertutup oleh tulang rawan, dimana kapasitas regenerasi intrinsiknya rendah karena anatomisnya yang avaskuler. 2 Oleh karena itu, nutrisi tulang rawan sangat bergantung dari cairan sinovial dan dari lapisan subchondral. 10 Fakta bahwa suplai vaskuler dari tulang talus yang kurang, menyebabkan semakin berkurangnya kemampuan tulang rawan talus untuk sembuh setelah terjadi trauma.…”