Subchondral Pathology: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Shimozono, Yoshiharu; Brown, Alexandra J.; Murawski, Christopher D.; Gomaa, Mohamed; Kong, Siu Wah; Vaseenon, Tanawat; Takao, Masato; Glazebrook, Mark; Ackermann, Jakob; Adams, Samuel B.; Andrews, Carol L.; Angthong, Chayanin; Batista, Jorge; Baur, O; Bayer, Steve; Becher, Christoph; Berlet, Gregory C.; Boakye, Lorraine; Buda, Roberto; Calder, James; Canata, Gian Luigi; Carreira, Dominic S.; Clanton, Thomas O.; Dahmen, Jari; D’Hooghe, Pieter; DiGiovanni, Christopher W.; Dombrowski, Malcolm E.; Drakos, Mark C.; Ferkel, Richard D.; Ferrao, Paulo N. F.; Fortier, Lisa A.; Giza, Eric; Görtz, Simon; Haleem, Amgad M.; Hamid, Kamran S.; Hangody, László; Hannon, Charles P.; Haverkamp, Daniël; Hertel, Jay; Hintermann, Beat; Hogan, MaCalus V.; Hunt, Kenneth J.; Hurley, Eoghan T.; Karlsson, Jón; Kearns, Stephen; Kennedy, John G.; Kerkhoffs, Gino M. M. J.; Kim, Soo Hyun; Labib, Sameh A.; Lambers, Kaj T. A.; Lee, Jin Woo; Lee, Keun Bae; Ling, Jeffrey S.; Longo, Umile Giuseppe; Marangon, Alberto; McCollum, Graham; Mitchell, Adam; Mittwede, Peter N.; Nehrer, Stefan; Niemeyer, Philipp; Nunley, James A.; O’Malley, Martin J.; Osei-Hwedieh, David O.; Paul, Jochen; Pearce, Christopher J.; Pereira, Hélder; Popchak, Adam; Prado, Marcelo Pires; Raikin, Steven M.; Reilingh, Mikel L.; Rothrauff, Benjamin B.; Schon, Lew C.; Simpson, Helene; Smyth, Niall A.; Sofka, Carolyn M.; Spennacchio, Pietro; Stone, James W.; Sullivan, Martin; Tanaka, Yasuhito; Thordarson, David B.; Tuan, Rocky S.; Valderrábano, Víctor; Bergen, Christiaan J. A. van; Dijk, C. Niek van; Dijk, Pim A. D. van; Vannini, Francesca; Walther, Markus; Wiewiorski, Martin; Xu, Xiangyang; Yasui, Youichi; Hua, Yinghui; Yoshimura, Ichiro; Younger, Alastair; Zhang, Zijun

doi:10.1177/1071100718781866

Cited by 27 publications

(12 citation statements)

References 27 publications

(42 reference statements)

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“…Another explanation for this finding may be that the subchondral bone plate may have resulted in inferior quality. 13 , 31 - 35 This theory is supported by the findings of Reilingh et al . 27 in the present study showing that 91% of the secondary lesions showed a depressed subchondral bone plate.…”

Section: Discussionsupporting

confidence: 71%

Evidence-based Treatment of Failed Primary Osteochondral Lesions of the Talus: A Systematic Review on Clinical Outcomes of Bone Marrow Stimulation

et al. 2021

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Objective The purpose of this study is to systematically review the literature and to evaluate the outcomes following bone marrow stimulation (BMS) for nonprimary osteochondral lesions of the talus (OLT). Design A literature search was performed to identify studies published using PubMed (MEDLINE), EMBASE, CDSR, DARE, and CENTRAL. The review was performed according to the PRISMA guidelines. Two authors separately and independently screened the search results and conducted the quality assessment using the Methodological Index for Non-Randomized Studies (MINORS). Studies were pooled on clinical, sports, work, and imaging outcomes, as well as revision rates and complications. The primary outcome was clinical success rate. Results Five studies with 70 patients were included in whom nonprimary OLTs were treated with secondary BMS. The pooled clinical success rate was 61% (95% confidence interval [CI], 50-72). The rate of return to any level of sport was 83% (95% CI, 70-91), while the return to pre-injury level of sport was 55% (95% CI, 34-74). The rate of return to work was 92% (95% CI, 78-97), and the complication rate was assessed to be 10% (95% CI, 4-22). Imaging outcomes were heterogeneous in outcome assessment, though a depressed subchondral bone plate was observed in 91% of the patients. The revision rate was 27% (95% CI, 18-40). Conclusions The overall success rate of arthroscopic BMS for nonprimary osteochondral lesions of the talus was 61%, including a revision rate of 27%. Return to sports, work, and complication outcomes yielded fair to good results.

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Section: Discussionsupporting

confidence: 71%

Evidence-based Treatment of Failed Primary Osteochondral Lesions of the Talus: A Systematic Review on Clinical Outcomes of Bone Marrow Stimulation

et al. 2021

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“…The mean age was 38.1 ± 7.6 years (range, 27-50). The mean body mass index was 25 ± 1.9 (range, [22][23][24][25][26][27][28]. In 16 cases (76.2%), a history of ankle sprain was reported.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Retrograde Drilling and Bone Graft for Hepple Stage V Subchondral Bone Lesion of Talus Using 3D Image–Based Navigation-Assisted Endoscopic Technique

Wu,

Zhong,

Wei

et al. 2023

Foot Ankle Int.

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Background: Retrograde drilling remains technically challenging, because of the difficulty of identifying the accurate location of cysts during surgery. This study’s aim was to evaluate the 3-dimensional (3D) image–based surgical navigation-assisted endoscopic retrograde drilling technique for subchondral bone lesions of the talus. Methods: From March 2017 to June 2020, a total of 21 cases with Hepple stage V subchondral bone lesions of the talus were treated with 3D image–based surgical navigation-assisted endoscopic retrograde drilling and bone graft technique. Arthroscopic views were categorized per Pritsch classifications. The correlation between the drilled tunnel with preoperative cystic lesions were assessed under postoperative computer tomographic (CT) scans. The American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS) scores, and Foot and Ankle Ability Measure (FAAM) sports scales were evaluated at the preoperative and final consultation. All complications were recorded. Results: On postoperative CT scans, in 20 cases (95.2%), the drilled tunnel was judged to have been in the center of previous cysts. Only 9 cases (42.9%) showed intact normal cartilage (grade 0, group A); 12 cases (57.1%) had intact, but soft, cartilage (grade I, group B). The median follow-up time was 24 (24, 30) months, and at final follow-up, there were no significant differences between the mean AOFAS and VAS scores in both groups (89.0 ± 6.4 vs 88.3 ± 7.0 and 1 vs 0.5) or postoperative FAAM sports scales (28.2 ± 2.2 vs 26.6 ± 4.9, P = .363). Two patients had revision surgery in group B. Conclusion: The 3D image–based surgical navigation-assisted endoscopic retrograde drilling and bone graft technique for the subchondral bone lesions of the talus in this small case series showed encouraging results. Level of Evidence: Level IV, retrospective case series.

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“…21 , 58 , 85 , 86 In the presence of subchondral bone cysts or necrosis, the substitution of the complete osteochondral unit addresses both cartilage and underlying disease. 14 Conversely, cancellous bone graft augmentation 6 , 14 , 23 , 54 and/or implementing the "sandwich technique" should be considered when managing similar defects with scaffold-based techniques. [87][88][89][90] OATS/mosaicplasty's main advantage is its fastest RTS time and replacing the defect with native hyaline cartilage tissue.…”

Section: Treatment Algorithm In the Athletementioning

confidence: 99%

“…2 , 4-7 Typically, patients are 20-35-year-old male athletes experiencing chronic ankle pain, decreased range of motion, and joint effusion, especially during or after sports activities, and compromised quality of life. 2 , 6 , 8-10 Due to the chondrocytes' low regeneration potential and the recent findings revealing subchondral bone architecture's role in cartilage homeostasis, repair durability, and overall clinical outcomes, [11][12][13][14][15][16][17] OLT treatment remains a challenging topic in orthopedics. 4 , 9 , 18 Many surgical techniques have been developed during the last few decades for treatment [18][19][20][21] and can be summarized in four strategical categories 2,22 :…”

Section: Introductionmentioning

confidence: 99%

Osteochondral lesions of the talar dome in the athlete: what evidence leads to which treatment

Fermín

Macchiarola

Zampeli

et al. 2022

Journal of Cartilage & Joint Preservation

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Subchondral Pathology: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Abstract: This international consensus statements regarding subchondral pathology of the talus derived from leaders in the field will assist clinicians in the assessment and management of this difficult pathology.

Cited by 27 publications

References 27 publications

Evidence-based Treatment of Failed Primary Osteochondral Lesions of the Talus: A Systematic Review on Clinical Outcomes of Bone Marrow Stimulation

Evidence-based Treatment of Failed Primary Osteochondral Lesions of the Talus: A Systematic Review on Clinical Outcomes of Bone Marrow Stimulation

Retrograde Drilling and Bone Graft for Hepple Stage V Subchondral Bone Lesion of Talus Using 3D Image–Based Navigation-Assisted Endoscopic Technique

Osteochondral lesions of the talar dome in the athlete: what evidence leads to which treatment

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