Osteochondral lesion of the talus

NewsBot · Dec 7, 2024

Advancements in the treatment of osteochondral lesions of the talus
Lianjie Cheng, Xuena Wang
J Orthop Surg Res. 2024 Dec 6;19(1):827

Osteochondral lesions of the talus (OLT) are common ankle joint pathologies, often caused by traumatic or non-traumatic factors. Due to the anatomical characteristics and limited blood supply of the talus, the spontaneous healing capacity of OLT is poor, posing challenges for clinical treatment. Traditional treatments include conservative therapy and surgical interventions, but their efficacy is limited. In recent years, significant advancements in OLT treatment have been achieved with developments in biomaterials science, cell biology, and tissue engineering. This article summarizes the latest research progress in various treatment methods, including conservative treatment, bone marrow stimulation, chondrocyte transplantation, and osteochondral grafting, and evaluates the role of biological augmentation agents such as platelet-rich plasma (PRP) and concentrated bone marrow aspirate (CBMA) in promoting cartilage repair. Additionally, the application of biological scaffold technology offers new prospects for cartilage regeneration. Although emerging therapies show potential in clinical practice, further research is needed to evaluate their long-term efficacy, indications, and safety. This article aims to provide valuable references for clinicians, researchers, and policymakers, promoting the development and refinement of OLT treatment strategies.
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NewsBot · Dec 18, 2024

Prospective comparison of two different surgical technique in the treatment of deep osteochondral lesions of the talus: mosaicplasty versus all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond
Mustafa Özyıldıran et al
Arch Orthop Trauma Surg. 2024 Dec 16;145(1):46

Introduction: There are various surgical techniques applied for the treatment of osteochondral lesions of the talus (OLT). The mosaicplasty technique is one of the most commonly used methods for deep lesions. The all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond is a novel method as an alternative to the mosaicplasty. This study aims to compare the clinical and radiological results of these two different surgical techniques in the treatment of deep OLT.

Materials and methods: From September 2019 to July 2021, 30 patients with deep osteochondral lesions of the talus were randomly divided into two groups for either mosaicplasty or the all-arthroscopic technique, and they were evaluated prospectively. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analog scale (VAS) scores were evaluated within and between groups preoperatively and postoperatively. Radiological assessments were performed at 6th and 12th month postoperatively according to the magnetic resonance observation of cartilage repair tissue (MOCART) scale.

Results: Mosaicplasty was applied to 15 patients, and all-arthroscopic technique was applied to 15 patients. 14 of the patients were female and 16 were male; the mean age was 38.1. Within-group evaluations revealed significant improvements in AOFAS and VAS scores at postoperative 6th and 12th months (p < 0.05). There was no significant difference between the treatment groups in comparison of clinical scores at any time period. There was no significant difference between the two methods according to the total MOCART scores (p > 0.05). However, the all-arthroscopic technique was more successful in terms of "border integration" and "repair tissue structure" (p < 0.05). Age, body mass index (BMI) and lesion surface area were not correlated with clinical scores.

Conclusions: In terms of clinical and radiological scores, similar results were obtained in the treatment groups. Both surgical techniques were found to be effective in the treatment of deep OLT.
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NewsBot · Dec 22, 2024

Comparative Retrospective Study of PLLA and PLLA/HA Pins for Osteochondral Fragment Fixation in Osteochondral Lesion of the Talus
Dan Moriwaki et al
Source

Background:
Postoperative osteolysis may be observed around poly-l-lactic acid (PLLA) pins in osteochondral fragments fixation for an osteochondral lesion of the talus (OLT). Hydroxyapatite (HA) improves biocompatibility, osteoconductivity, and mechanical strength when added to PLLA. This study aimed to compare the characteristics of osteolysis and clinical outcomes of fixation for OLT with PLLA pins vs PLLA/HA pins.
Methods:
Thirty-one ankles undergoing fixation with bioabsorbable pins for OLT were included. Fourteen ankles were fixed with PLLA/HA pins and 17 ankles with PLLA pins. Magnetic resonance imaging (MRI) was taken pre- and postoperatively at 1 year. Osteolysis around pins, bone marrow edema (BME) in the talus, and pin insertion angle on MRI, the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the visual analog scale (VAS) pain score were compared between the 2 groups pre- and postoperatively at 1 year. AOFAS score at the final follow-up was also compared between the 2 groups.
Results:
The osteolysis area was significantly smaller in the PLLA/HA group in both coronal and sagittal planes on MRIs obtained 1 year postoperatively. There were no significant differences in osteolysis frequency, BME area, AOFAS score, and VAS pain score. Lower pin insertion angles measured on either sagittal or coronal planes were generally associated with greater amounts of osteolysis.
Conclusion:
We did not find superiority using PLLA/HA pins compared with PLLA pins to fixate talar osteochondral fragments. However, PLLA/HA pin use was associated with less osteolysis around pins compared with PLLA pins.
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NewsBot · Dec 24, 2024

Therapeutic effect of joint injection of platelet-rich plasma combined with shock wave on osteochondral injury of talus
Ying Liu et al
Zhongguo Gu Shang. 2024 Dec 25;37(12):1224-8.

Objective: To explore clinical efficacy of platelet rich plasma (PRP) injection combined with extracorporeal shock wave therapy (ESWT) in treating osteochondral lesion of talus (OLT) with typeⅡa.

Methods: From January 2022 to June 2022, 45 patients with typeⅡa OLT were treated with PRP arthroscopic injection combined with ESWT, including 29 males and 16 females; aged from 18 to 63 years old with an average of(37.7±10.3) years old;the courses of disease ranged from 6 to 20 with an average of (13.3±4.8) months. American Foot and Ankle Association ankle and foot (AOFAS) score, visual analogue scale (VAS), cartilage injury volume and bone marrow edema volume were evaluated for ankle joint function and osteochondral recovery of talus before treatment, 3 and 6 months after treatment.

Results: All patients were followed for at least 6 months. No related complications occurred in all patients. AOFAS score were increased from(68.3±3.6) before treatment to (83.7±3.2) and (90.8±2.2) at 3 and 6 months after treatment, respectively (P<0.05). VAS decreased from (5.2±1.2) before treatment to (3.2±0.8) and (1.9±1.2) at 3 and 6 months after treatment (P<0.05). The injury volume of cartilage and subchondral bone decreased from (71.0±42.5) mm3 before treatment to (50.6±31.5) mm3 and (36.5±27.3) mm3 at 3 and 6 months after treatment (P<0.05). The bone marrow edema volume decreased from (1 182.7±675.1) mm3 before treatment to (656.1±455.1) mm3 and (382.1±485.6) mm3 at 3 and 6 months after treatment (P<0.05).

Conclusion: PRP intraarticular injection combined with ESWT for the treatment of typeⅡa OLT could alleviate clinical symptoms, effectively improve joint function, and promote cartilage repair and bone marrow edema absorption.
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NewsBot · Dec 31, 2024

Concomitant chronic lateral ankle instability affects postoperative functional outcomes in patients with osteochondral lesions of the talus, but does not affect cartilage repair after restoration of ankle stability
Jiayao Zhang M.D. et al
Arthroscopy: The Journal of Arthroscopic & Related Surgery 26 December 2024

Purpose
To investigate the effect of concomitant chronic lateral ankle instability (CLAI) on postoperative clinical outcomes in patients with osteochondral lesions of the talus (OLTs).
Methods
Patients who underwent surgery for OLTs between January 2018 and May 2022 were retrospectively evaluated. OLT procedures involved debridement, microfracture, or bone grafting, while concomitant CLAI underwent lateral ligament repair or reconstruction. Functional assessments included the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and Tegner Score, with a minimum follow-up of 24 months. Cartilage repair was evaluated using the MOCART (magnetic resonance observation of cartilage repair tissue) 1 and MOCART 2.0 scores based on postoperative MRI. Additionally, multiple linear regression analysis was performed to explore the effects of potential factors, and Spearman correlation coefficients (rs) were calculated to assess the relationship between these factors and outcome scores.
Results
A total of 85 patients were included, with 39 in OLT group and 46 in OLT with CLAI group. The mean follow-up times were 46.95±17.00 months (range, 24-76 months) and 41.80±15.10 months (range, 24-76 months), respectively (P=0.347). Compared to OLT group, OLT with CLAI group showed lower postoperative AOFAS and FAOS scores, with a significantly smaller overall improvement in AOFAS scores (p<0.05). There was no significant difference between the groups in the number of patients achieving the minimal clinically important difference (MCID) in functional scores. Multiple linear regression analysis showed that CLAI surgery negatively affected postoperative AOFAS and FAOS scores (std β=-0.344, p=0.001; std β=-0.332, p=0.001), with Spearman analysis indicating a moderate correlation (rs=-0.442, p<0.001; rs=-0.339, p=0.002). There were no significant differences observed between groups in terms of MOCART 1 or MOCART 2.0 scores (MOCART 1.0, 61.52±12.38 vs. 65.89±14.47; MOCART 2.0, 68.70±16.53 vs. 73.75±14.76; P>0.05), and multiple linear regression as well as Spearman analysis did not yield positive results.
Conclusion
Concomitant CLAI had lower postoperative functional outcomes in OLT patients, but no impact on cartilage repair was observed after restoration of ankle stability.
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NewsBot · Dec 31, 2024

Osteochondral lesions of Talus in unexplained chronic
ankle pain
Rahi Akther Rasool, Muzaffar Ahmad Malla, Ansar Ul Haq Lone and
Source

Osteochondral lesions of the talus can present as a late complication of ankle injuries. Early and accurate
diagnosis is important as talar integrity is required for optimal function of the ankle. Osteochondral
lesions of the talus (OTL) are among those injuries that we should not fail to recognize, especially
following any type of hind foot injury. In our study Forty patients with unexplained post traumatic
chronic ankle pain were included and after thorough clinical evaluation and radiography were advised
MRI Ankle to look for the possible causes of the pain. Three (7.5%) of the patients were reported as
Osteochondral lesions of the talus which were initially missed as being normal on ankle radiographs.
This study reveals that a high index of suspicion has to be kept for OCTs in patients with ankle pain
following any hind-foot trauma.
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NewsBot · Jan 4, 2025

Osteochondral Lesions of the Talus with Small Cysts May Not Affect the Outcome of Arthroscopic Microfracture: A Systematic Review and Meta-analysis
Yu Pan et al
Foot and Ankle Surgery 3 January 2025

Background
The optimal treatment of Osteochondral lesion of the talus (OLT) for subchondral bone cysts (SBCs) has not been finalized. The purpose of this systematic review and meta-analysis was to define whether OLT with small SBCs will affect the clinical outcomes of OLTs after arthroscopic microfracture.
Methods
We searched the Embase, Cochrane Library and PubMed databases up to May 13, 2024 for eligible comparative studies. The methodological index for non-randomized studies (MINORS) were used for assessing the methodological quality. The Review Manager 5.4 software was applied to perform the statistical analysis.
Results
A total of 4 studies involving 257 patients were included in this meta-analysis. No significant difference was noted in American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot Scale, the improvement of Foot and Ankle Ability Measure- Activities of Daily Life (FAAM-ADL) and Foot and Ankle Ability Measure (FAAM-SP), Tegner Score and Visual Analogue Scale (VAS) between the cyst and noncyst group. The noncyst group was statistically significant in term of FAAM-ADL and FAAM-SP. Radiological outcomes in the cyst group had improved after arthroscopic microfracture.
Conclusions
Based on the results of the present study, there are no clinical differences with the technique of bone marrow stimulation between simple and cystic ostechondral lesions of talus with depth smaller than 5-6 mm, with respect to the medial part of talus and referring to age younger than 40 years old.
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Osteochondral lesion of the talus

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Osteochondral lesion of the talus

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NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Osteochondral Lesions in Surgically Treated Hallux Valgus

Is a osteochondral lesion of the distal tibia something that heals by it's self.

Fracture/tendonosis/osteochondral lesion

Osteochondral defect 3rd metatarsal head

Osteochondral Defect - 3.5 years later

Osteochondral Defect at Medial Talar Dome: Preferred Treatment?

Tactile function of the foot in children with upper motor neuron lesions

Share This Page

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