Regenerative treatment of osteochondral lesions of distal tibial plafond

Baldassarri, Matteo; Perazzo, Luca; Ricciarelli, Marco; Natali, Simone; Vannini, Francesca; Buda, Roberto

doi:10.1007/s00590-018-2161-7

Cited by 14 publications

(57 citation statements)

References 27 publications

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“…Ten articles were included in the review (Figure 1, Table 1). 2,3,5,10,13,18,20,24,29,36 All studies were published in 2000 or later and were deemed level 4 evidence, except for Elias et al 15 The mean Methodological Index for Non-randomized Studies score of the 5 surgical treatment studies 3,12,23,27,33 was 8.6 (range, 8-10); each of these was a noncomparative case series.…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, Cuttica et al 12 performed lateral ankle ligament stabilization in 3 of 13 patients (2 isolated, 1 coexisting). Furthermore, Baldassarri et al, 3 in evaluating BMDCT for isolated OLTPs, found inversion ankle sprain as a traumatic cause in 20 of 27 patients and noted that those with impingement findings had a worse rate of improvement in AOFAS scores at 12-month follow-up (P ¼ .029). The findings from these studies suggest that additional ankle pathologies such as instability and trauma may affect the incidence, natural history, or outcomes of treatment of OLTPs.…”

Section: Discussionmentioning

confidence: 99%

“…In other studies, zone 4 was frequently noted to be one of the most involved zones. 3,21,29,41 Biomechanical data have shown that zone 8 has the lowest puncture strength on the plafond, significantly lower than that of zone 3 and zone 7, which are the strongest areas. 39 Differences in locations in clinical data from these laboratory data are likely due to clinical and traumatic forces on the plafond.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies 3,33 evaluated imaging outcomes after treatment, utilizing the MOCART scoring system (magnetic resonance observation of cartilage repair tissue) (Table 3). Patients included those with distal tibial osteochondral lesions: isolated ¼ osteochondral lesion of the tibial plafond only; coexisting ¼ osteochondral lesions of the tibial plafond and talus.…”

Section: Records Idenɵfiedmentioning

confidence: 99%

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Osteochondral Lesions of the Distal Tibial Plafond: A Systematic Review of Lesion Locations and Treatment Outcomes

Allahabadi

Allala

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Osteochondral lesions of the tibial plafond (OLTPs) remain less common than osteochondral lesions of the talus (OLTs), but recognition of the condition has increased. Purpose: To systematically evaluate the literature on lesion locations and treatment outcomes of OLTPs, whether in isolation or in combination with OLTs. Study Design: Systematic review; Level of evidence, 4. Methods: A search was performed using the PubMed, Embase, and CINAHL databases for studies on lesion locations or with imaging or treatment outcomes of OLTPs. Case reports and reports based on expert opinion were excluded. Lesion locations as well as outcome measure results were aggregated. The Methodological Index for Non-randomized Studies score was used to assess methodological quality when applicable. Results: Included in this review were 10 articles, all published in 2000 or later. Most studies were evidence level 4, and the mean Methodological Index for Non-randomized Studies score was 8.6 (range, 8-10). Overall, 174 confirmed OLTP cases were identified, and the mean patient age was 38.8 years. Of the 157 lesions with confirmed locations, the most common was central-medial (32/157; 20.4%). Of 6 studies on treatment outcomes, all but 1 evaluated bone marrow stimulation techniques. Microfracture of small lesions (<150 mm2) was the most common treatment utilized. Imaging and functional outcomes appeared favorable after treatment. The data did not support differences in outcomes between isolated OLTPs and OLTPs with coexisting OLTs. Conclusion: Osteochondral lesions of the distal tibia most commonly occurred at the central-medial tibial plafond. Microfracture of small lesions was the most common treatment utilized, and clinical and magnetic resonance imaging results were favorable, although data were heterogeneous. Areas for future research include the following: the effect of patient factors and additional pathologies on outcomes; larger or deeper lesion treatment; more direct comparisons of outcomes between kissing or coexisting lesions and isolated lesions; and head-to-head comparison of treatments, such as microfracture, bone marrow–derived cell transplantation, and osteochondral autografts/allografts.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Records Idenɵfiedmentioning

confidence: 99%

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Osteochondral Lesions of the Distal Tibial Plafond: A Systematic Review of Lesion Locations and Treatment Outcomes

Allahabadi

Allala

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…The reports of new attempts are as follows: bone marrow–derived cell transplantation, 8 micronized allograft cartilage matrix transplantation, 9 and bone marrow aspirate concentrate combined with biologic scaffold transplantation 10 . These techniques have satisfactory clinical results but they are still under development because long-term and high-evidence studies are required.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Antegrade Cancellous Bone Autotransplantation for Osteochondral Lesions of the Tibial Plafond

Hayashi

Tanaka

2019

Arthroscopy Techniques

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Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. We introduce a technique of arthroscopic antegrade cancellous bone autotransplantation; fibrocartilage regeneration can be expected for the cartilaginous lesion while bony lesion is replaced with the normal bone using this technique.

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