Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. The lesion’s location does not technically limit the ability to perform the conventional surgical treatments discussed in this chapter as it does other restorative procedures, such as osteochondral autograft or allograft transplantation (i.e., osteoarticular transfer system [OATS]) or autologous chondrocyte implantation (ACI), which require greater access to the talar dome. They may also be called osteochondritis dessicans or osteochondral fractures. 1977 Sep; 124 (3):667–673. It is often associated with a traumatic injury such as a severe ankle sprain. Yvars MF. The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. 17 Osteochondral Lesions of the Talus MARK E. EASLEY, STEVEN D. SIDES, AND ALISON P. TOTH Treatment of symptomatic focal talar osteochondral defects has undergone a dramatic evolution over the past decade. [1] Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. Osteochondral fractures of the dome of the talus. Author information: (1)1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Rm 2A061, 2/F, New Extension Block, Prince of Wales Hospital, 30-32 Ngan Shing St, Shatin, New Territories, Hong Kong, SAR. … Foot Ankle Int 1999; 20( 8): 474– 480. Talar Dome. Osteochondral lesion of the talus in children: Are there MRI ... Keywords Ankle .Children .MRI .OCD .OLT .Osteochondritisdissecans .Osteochondrallesion .Talar dome Introduction Osteochondritis dissecans (OCD) ... 2 Department of Radiology, Children ’s Hospital … These sequences were performed, and their ability to distinguish the osteochondral lesions from normal bone, cartilage, and surrounding soft tissue was assessed. J Bone Joint Surg Am 1999; 81:1229-1235. Clinical management of these lesions is based on whether or not the fragments are attached. Nine osteochondral lesions of the talar dome were treated arthroscopically. The most common sites are the posteromedial (53%) ( Fig. The purpose of our research was to evaluate the incidence of osteochondral lesions of the talus (OLT) with peroneal tendon pathologic features according to the magnetic resonance imaging (MRI) findings. 1, pp. Diagnosis. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans “Osteo” means bone and “chondral” refers to cartilage. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Foot Ankle Int 1999; 20:474-480. incidence 69% of ankle fractures; 70% of ankle sprains; 10% are bilateral A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Medial lesions tend to be deeper and cup shaped. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. 1976 Jan-Feb;(114):185–191. Purpose: The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. Clin Orthop Relat Res. Furthermore, the ankle joints of five volunteers without osteochondral lesions of the medial talar dome and one volunteer with an osteochondral lesion of the medial talar dome were imaged. It is relatively prevalent and are an important cause of ankle morbidity. Radiology. Retrograde drilling of osteochondral lesions of the medial talar dome. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. Crossref, Medline, Google Scholar; 12. A medial talar dome injury is seen on a mortise x-ray view. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Treatment of Osteochondral Lesions of the Talar Dome James W. Stone MD Key Points Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. Management of symptomatic osteochondral lesions of the talus (OLT) is challenging given the poor healing potential of articular cartilage. 1 ) and anterolateral (46%) talar dome ( 1 ). Medline, Google Scholar This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). Talar dome chondral and osteochondral lesions are a common cause of ankle pain and subjective instability. Materials and method: This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March … A partial fluid cleft at its posterior margin and a mild subchondral oedema suggests an unstable lesion. Crossref, Medline, Google Scholar; 7 Kumai T, Takakura Y, Higashiyama I, Tamai S. Arthroscopic drilling for the treatment of osteochondral lesions of the talus. Few studies have evaluated the incidence of talar dome lesions and injuries to the peroneal tendons occurring concomitantly. Osteochondral lesions may also involve the talar dome, most frequently the medial aspect. We studied the value of MR imaging in determining the stability of the osteochondral fragments. Two patients (a 16-year-old boy) had two recent osteochondral fractures, a… (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. Nine osteochondral lesions of the talar dome were treated arthroscopically. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. Patients tend to present… (A) Unstable medial talar dome osteochondral lesion of the talus. Art. Ankle Traction During MRI of Talar Dome Osteochondral Lesions. Talar dome lesions are usually caused by an injury, such as an ankle sprain. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Bale RJ, Hoser C, Rosenberger R, Rieger M, Benedetto KP, Fink C. Osteochondral lesions of the talus: computer-assisted retrograde drilling—feasibility and accuracy in initial experiences. Lee RKL(1), Griffith JF(1), Law EKC(1), Ng AWH(1), Yeung DKW(1). If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. There is an osteochondral fracture of the posterolateral part of the talar dome; the fractured fragment is detached and flipped upside down, so that the articular cartilage is visible at its inferior surface. OCDs of the talus represent damage to the articular surface of the talar dome in the ankle joint. Treatment of Osteochondral Lesions of the Medial Talar Dome with Osteochondral Autograft Transplantation Operative Techniques in Orthopaedics, Vol. Retrograde drilling of osteochondral lesions of the medial talar dome. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma; Epidemiology . “Osteo” means bone and “chondral” refers to cartilage. Talar dome lesions are usually caused by … The talus is a bone in the foot that helps form the ankle joint. The lesions were treated with simple ablation of the loose body. Two patients (a 16-year-old boy) had two recent osteochondral fractures, anterior and superior lateral, with a free fragment detached in the joint. A talar dome lesion can be difficult to diagnose because the precise site of the pain can be hard to pinpoint. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. Subtle transchondral fractures of the talar dome: a radiological perspective. Most OCD of the talar dome (8a) treated non-operatively improve or show no change on MRI at an average of 13.7 months, and marrow edema and subchondral cysts are not reliable indicators of progression. A similar pattern was subsequently described at the talar dome in 1922 by Kappis and colleagues.3, 4 The etiology of these lesions remains controversial today with numerous proposed biomechanical explanations and causes in the orthopaedic, pediatric, radiology… Lesions in the medial third of the talar dome were significantly larger in surface area involvement and deeper than those at the lateral talar dome. There is also reactive bone marrow edema of the distal tibia and the talus. Many of these lesions are first diagnosed by plain film. (B) Lesion debrided to stable margins. To diagnose this injury, the surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking or limited motion within that joint. Particulated juvenile cartilage allograft transplantation. Smith GR, Winquist RA, Allan NK, Northrop CH. 3 Autogenous bone grafting for the treatment of talar dome lesions 20, No. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage. These sequences were performed, and their ability to distinguish the osteo-chondral lesions from normal bone, carti- Talar dome lesions are usually caused by … 2 of 7 Posadzy et al: Staging of Osteochondral Lesions of the Talus Figure 1: Location of the OCL according to the mechanism of trauma. RSNA, 2009 Supplemental material: ... 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