Osteochondral lesions of the talus are a reasonably infrequent cause of long-standing ankle pain and stiffness and are often the result of a severe ankle sprain type injury. Management of symptomatic osteochondral lesions of the talus (OLT) is challenging given the poor healing potential of articular cartilage. Maya Patel1 & Michael L. Francavilla2,3 & J. Todd R. Lawrence3,4 & Christian A. Barrera2 & Michael K. Nguyen2 & Cruz Longoria5 & Jie C. Nguyen2,3 Received: 12 January 2020 /Revised: 23 March 2020/Accepted: 30 March 2020 Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): INTRODUCTION. The use of MRI enables one to evaluate the tibiotalar joint for synovitis, stress reaction, avascular necrosis, chondritis and osteoarthritis in addition to osteochondral lesions. Total lesion size unchanged. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. Fig. A T2 high-signal line between the fragment and its bed on MRI is known as a reliable indicator of an unstable lesion. Arthroscopic management of transchondral talar dome fractures (osteochondritis dissecans) and anterior impingement lesions of the ankle joint. “Osteo” means bone and “chondral” refers to cartilage. (c) T-2 (a) The oblique coronal MRI demonstrating a lesion in 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; ... During his workup, an MRI shows a 1x1 cm lateral talar osteochondral defect (OCD). Although magnetic resonance imaging (MRI) is commonly used in the preoperative evaluation of OLTs, the reliability of the MRI measurement … 1, pp. Background and purpose - The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. 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. Osteochondral lesions of the talus are diagnosed with a medical history, thorough physical examination, X-rays, CT and MRI. SCIENTIFIC ARTICLE Osteochondral lesion of the talus in children: Are there MRI findings of instability? [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. However, the lesion exhibits various conditions even … They may also be called osteochondritis dessicans or osteochondral fractures. The clinical outcome was recorded with ankle function scores, and MRI … When planning the treatment of osteochondral lesions of the talus, it is important to evaluate the articular cartilage to distinguish between stable and unstable lesions (1,2).Radiography cannot directly depict the cartilage surface ().Both magnetic resonance (MR) imaging and ankle arthroscopy are excellent tools commonly used to evaluate ankle cartilage (3 –5). 1 ) and anterolateral (46%) talar dome ( 1 ). 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. MRI: Medial osteochondral lesion of the talus, with central piece of bone. Osteochondral lesions of the talus. The presence of an osteochondral lesion may initially go undetected and may manifest many months after the initial ankle injury. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. 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. Classification of osteochondral lesions of the talus using MRI. 36, in a large series of patients with osteochondral lesions of the talus that were treated with microfracture, reported no treatment failures for lesions with an average diameter (length and width) of <15 mm. Purpose: The purpose of this study was to compare outcomes of chondroplasty versus microfracture versus osteochondral autologous transplantation (OAT) in patients with osteochondral lesions of the talus (OLT).Methods: After prospective sample size analysis, patients with symptomatic, recalcitrant Ferkel class 2b, 3, and 4 OLT were randomized to chondroplasty, microfracture, or OAT … Treatment of talar OCLs can be conservative or surgical, depending on whether the lesion is unstable or refractory to conservative management. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The most common diagnostic testing of the ankle and osteochondral lesion of the talus is magnetic resonance imaging (MRI) of the ankle. An osteochondral lesion of the distal tibia and fibula has been thought of as a rare condition, although it is located in the same weight-bearing joint as an osteochondral lesion of the talus (OLT). We report the outcome of a nonoperative treatment for symptomatic OCL. Talar dome lesions are usually caused by … Perform the … Radiographs showed a suspicious area on the lateral talar dome. The type of surgery that is required for your osteochondral lesion depends on its size, the age of the patient, the location of the osteochondral lesion, and its characteristics on MRI. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. You JY(1)(2), Lee GY(1)(3), Lee JW(1), Lee E(1), Kang HS(1). The most common sites are the posteromedial (53%) ( Fig. Lesion size is a major determinant of treatment strategy for osteochondral lesions of the talus (OLTs). Purpose: The purpose of this study was to show that magnetic resonance imaging (MRI) can accurately and noninvasively evaluate the articular cartilage overlying osteochondral lesions of the talus, using arthroscopy as the standard, and provide information about lesion stability. Chuckpaiwong et al. Patients and methods - This study included 142 patients w … Series shows the case of a 25-years-old man, a sports and physically active patient, with chronic ankle pain, a lateral talus osteochondral lesion (OCL), and chronic ankle instability. Nonoperatively managed stage 5 osteochondral talar lesions. Art. Current guidelines suggest operative treatment for nondisplaced chronic lesions after a failed 3-6 month trial of conservative management. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). A classification system applicable to both MRI and arthroscopy is proposed. 3. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. (b) The sagittal MRI shows a thin fibrillated cartilage covering the osteochondral lesion in the medial aspect of the talar dome. CT is used to accurately diagnose the size of the lesion … Magnetic resonance imaging (MRI) of the ankle joint. This retrospective IRB-approved and HIPPA-compliant study included children with OLT, who underwent an ankle MRI examination between March 1, 2011, and May 31, 2018. Osteochondral lesions of the talus: change in MRI findings over time in talar lesions without operative intervention and implications for staging systems. Foot Ankle Int . Magnetic resonance imaging (MRI) is useful for evaluating the stability of an osteochondral lesion of the talus (OLT). An Osteochondral Lesion of the Distal Tibia and Fibula in Patients With an Osteochondral Lesion of the Talus on MRI: Prevalence, Location, and Concomitant Ligament and Tendon Injuries. … There are some new exciting developments in osteochondral lesions of the talus in terms of being able to replace the cartilage damage with cartilage either from cadavers or from synthetic scaffolds. 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. Arthroscopic Drilling for the Treatment of Osteochondral Lesions of the Talus. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Increased cyst formation compared to images of 2011, but diminished bone oedema. MRI of the ankle is performed to assess the ligaments, bones, and articular cartilage as well as the tendons and other soft tissues of the ankle joint [1, 2].Osteochondral lesions of the talar dome are a frequently encountered abnormality on MRI examination of the ankle. Magnetic resonance imaging (MRI) is the gold standard for evaluating osteochondral lesions and one should order this for chronic ankle pain unresponsive to nonsurgical care. Historically, a variety of terms have been used to refer to this clinical entity including osteochondritis dissecans, osteochondral fracture, and osteochondral defect. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Introduction. 2. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). 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. FIGURE 71-1 Osteochondral lesion of the talus. Fig. Magnetic resonance imaging (MRI) is widely used for diagnosing osteochondral lesions in the talus. Choi et al. Slight increase in degenerative changes of the ankle with limited cartilage damage of anterior distal tibia. They followed up 25 patients with osteochondral lesions in the talus and treated with arthroscopic microfracture. The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. A study by Verhagen and colleagues found MRI has a greater sensitivity in comparison to computed tomography (CT). The talar dome is the most common location for an osteochondral lesion in the ankle joint. 3 Pathophysiology of OCLs of the talus : Talar osteochondral lesions tend to involve the medial and lateral corners of the talar dome. The purpose of this study was to directly compare the MRI with the arthroscopic findings. [] Although majority may be associated with trauma, some may develop insidiously. 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