Osteochondral Defects . Dans la littérature, on trouve peu de cas de ce type de lésion et peu de renseignements sur le mécanisme de la blessure, les antécédents, les observations physiques et les recommandations thérapeutiques. Current complaints: Pain, mostly activity related. Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). <>stream Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. The blood supply to the talus is not as rich as many other bones in the body, and as a result injuries to the talus sometimes are more difficult to heal than similar injuries in other bones. Pain Physician. The necrotic fragment usually becomes revascularised and reattaches to the surrounding bone. H��W�V�J��C��Z�,��uי'B�9!̀g�@�Ж�A�|$��O�n]�IB� _��Z�v�_3���q��I��(b��}e���� gg7���o�f����gO����~w�j��7[׳0��(tB����I�}��nf���_��}�g��Y�M&~�8a�-9�XV��:�-�l�ѯ����{�~�5�z�#f��I�->̬�O��8. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. This site needs JavaScript to work properly. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). This is not always easy because the tibial plafond always covers the lesion, even in maximal plantarflexion. <>stream Generally, these lesions have been treated with either microfracture or debridement, and the long-term outcomes have been less than satisfactory. Percutaneous osteoplasty for the treatment of a painful osteochondral lesion of the talus: a case report and literature review. athletic injury; chiropractic; osteochondral lesion; tibial plafond. %PDF-1.2 tibial plafond is frequently observed when performing arthroscopic treatment for an osteochondral lesion of the talus (OLT) and is usu- ally resected during the arthroscopic procedure. 12 0 obj Background: Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. cartilage injury with associated subchondral fracture but without detachment Clinical Outcomes of Osteochondral Lesions of the Tibial Plafond Following Arthroscopic Microfracture Wonyong Lee, MD, Sterling Tran, BS, Minton T. Cooper, MD, Joseph S. Park, MD, and Venkat Perumal, MD Foot & Ankle International201940:9, 1018-1024 Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Abstract: 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. Osteochondral Defect ... Xrays- large cystic OCL in the anterior tibial plafond. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. x�+� � | (A) AP ankle; (B) Medial oblique ankle; (C) Lateral ankle, Axial PD (A), sagittal T1 (B) and T2 fat-sat (C) sequences of the right ankle 6 weeks after initial visit reveal a cup-shaped OCL in the posteromedial tibial plafond demarcated completely by a thin hypointense T1 and T2 line and minimal marrow edema (hypointense T1 and hyperintense T2 FS signals) deep to the lesion. Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. The necrotic fragment usually becomes revascularised and reattaches to the surrounding bone. 14 0 obj endobj The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. Epub 2014 Sep 10. HHS Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. The oval is the starting point, each rectangle is a factor in the decision-making process, and each rhombus is a selected approach and end point Introduction: L’examen par imagerie par résonance magnétique a révélé la présence d’une lésion ostéochondrale au dôme talien. Tibial Plafond Osteochondral Lesion.OrthopaedicsOne Cases.In: OrthopaedicsOne - The Orthopaedic Knowledge Network.Created Feb 10, 2011 07:46. Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. <>stream Les lésions ostéochondrales du plateau tibial comptent pour environ 2,6 % des lésions ostéochondrales de la cheville. Seo SS, Park JY, Kim HJ, Yoon JW, Park SH, Kim KH. 10 0 obj endobj ... For preoperative planning I always make a CT. Background: Osteochondral lesions of the distal tibial plafond are uncommon compared with talar lesions. Summary: Treatment of osteochondral lesions of the talus: a systematic review. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Its radiologic findings are similar to those of osteo- chondritis dissecans located elsewhere in … Osteochondral defects (OCD) or lesions (OCL) are focal areas of damage with articular cartilage damage and injury of the adjacent subchondral bone plate and subchondral cancellous bone. However, even with improvement in the symptoms of OLT without any postoperative Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. x�S�*�*T0T0 B�����i������ y8# Comparison of sagittal (A, B) and coronal (C, D) T2 fat-saturation images of the left ankle showing separation of the osteochondral fragment from the posterior tibial plafond with a fluid cleft and increased surrounding marrow edema at follow-up (June 21, 2017). With new interest in biologic treatments for osteochondral defects, we believe that bone marrow … The aim of our study was to … Medial Malleolar Osteotomy and Osteochondral Autograft Transfer for Osteochondritis Dissecans of the Distal Tibial Plafond. (A) Axial MRI Proton Density; (B) Sagittal MRI T1-weighted; (C) Sagittal MRI Fat-suppressed. �0D���Y��4IE�|�I�D_�ܒ��o�;7s��6�j$4̙ H�$Di�\(��l������D�}��=Q��9�N��\.\N�5(B�JՕ?j�u.�����t�\�X�푣��ΧL���/oaX†��,����.FSsg��>f����>>>/BBox[0 0 612 792]/Length 170>>stream The talus is the bottom bone of the ankle joint. 13 0 obj 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. Most recently the patient was referred to an orthopaedic foot and ankle specialist. Osteochondral autograft transfer for post-traumatic osteochondral defects of the anterolateral surface of the distal tibial plafond. He has ongoing pain, swelling. Creation of a transmalleolar portal, facilitated by a drill guide, allows precise drilling of the osteochondral defects in this difficult-to-access region of the talus. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. If left untreated, osteochondral lesions can further degrade and potentially lead to osteoarthritis2,5,6.How-ever, the treatment guidelines and prognostic indicators that The degree of injury ranges from a small crack to a piece of the bone breaking off inside the joint. x�]�� 6. <>stream Literature data do not report clinical records with significant number of cases and follow-up. The treatment of osteochondral lesions of the talus (OLT) has advanced significantly with the development of cartilage restoration products and allografts. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. Radiographs taken on November 23, 2016 reveal no finding indicating OCL in the ankle. Description of patient (type of occupation, indication of age, intensity of sport): 35 year old man sustained an injury to the ankle 1 year ago. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The talar dome is a trapezoid-shaped protuberance of the talus, 2.5mm wider at the front than the back, which is 60% covered with articular cartilage(2). 2009;6:524–9. Arthroscopic treatment of osteochondral lesions of the tibial plafond. endobj endobj Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. The second MRI in June 2017 demonstrated separation of the osteochondral fragment from the posterior tibial plafond with a fluid cleft and increased surrounding marrow edema, suggesting progression of the lesion since previous imaging (Figure 4). He presented with locking and giving way of the ankle with weight-bearing and pushing off the foot to the contralateral side. endstream A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Yabumoto H, Nakagawa Y, Yamada S, Mukai S, Mukaida S, Ninomiya S, Tsubouchi N, Matsuoka M, Tarumi E, Nakamura T. Trauma Case Rep. 2016 Jun 19;3:18-25. doi: 10.1016/j.tcr.2016.05.008. Ankle arthroscopic debridement of the injury, followed by microdrilling or microfractures of the subchondral bone arethe For this discussion, OLT will refer to a focal articular cartilage injury/deficit and underlying bony involvement in the form of edema, fracture, and/or cyst formation. Les radiographies n’ont révélé aucune fracture ni aucune atteinte ostéochondrale. Radiographs were negative for fracture or osteochondral involvement. A 17-year-old male competitive soccer player presented with a 6-7 month history of medial ankle pain after an inversion sprain. It is often used synonymously with osteochondral injury/defect and in the pediatric population. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans There are three possible explanations for the underreporting of this lesion in the radiology literature. %���� <>stream Axial PD MRI of current patient’s OCLTP with overlay of Elias et al’s…, Radiographs taken on November 23, 2016 reveal no finding indicating OCL in the…, Axial PD (A), sagittal T1 (B) and T2 fat-sat (C) sequences of the…, Comparison of sagittal (A, B) and coronal (C, D) T2 fat-saturation images of…, NLM A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. RESULTS: A total of 13 patients were included. The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. x�]�� <>stream 8 0 obj There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. steochondral lesions of the distal tibial plafond are rare—far less common than osteochondral lesions of the talus1-4. Its radiologic findings are similar to those of osteo- chondritis dissecans located elsewhere in the body. USA.gov. <>>>/BBox[0 0 612 792]/Length 170>>stream For this discussion, OLT will refer to a focal articular cartilage injury/deficit and underlying bony involvement in the form of edema, fracture, and/or cyst formation. BACKGROUND: Osteochondral lesions of the distal tibial plafond (OLTPs) are an uncommon problem. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. We describe two cases of an OLTP that were treated with retrograde osteochondral autograft. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans, and transchondral fracture. 2015 Aug;8(4):314-9. doi: 10.1177/1938640014548419. �0D���Y��4IE�|�I�D_�ܒ��o�;7s��6�j$4̙ H�$Di�\(��l������D�}��=Q��9�N��\.\N�5(B�JՕ?j�u.�����t�\�X�푣��ΧL���/oaX†��,����.FSsg��>f����>stream OCD usually causes pain during and after sports. A 26-year-old Han Chinese woman presented with a lesion on her left medial tibial plateau. An osteochondral lesion of the talar dome is an injury to the talus, which is a bone in the foot that along with the tibia forms the ankle joint. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. 2012 Sep-Oct;15(5):E743-8. ObjectivesOsteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. J Foot Ankle Surg. 9 0 obj Decision making is based on size, characteristics, and location of the lesion as well as type of surgical treatment. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for Tibial OCL . 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. In my experience these lesions have a good healing potential without developing a loose body. PubMed CrossRef Google Scholar. CrossRef Google Scholar There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 lesions (16%). 2009;6:524–9. The second MRI in June 2017 demonstrated separation of the osteochondral fragment from the posterior tibial plafond with a fluid cleft and increased surrounding marrow edema, suggesting progression of the lesion since previous imaging (Figure 4). endstream �0D���Y��4IE�|�I�D_�ܒ��o�;7s��6�j$4̙ H�$Di�\(��l������D�}��=Q��9�N��\.\N�5(B�JՕ?j�u.�����t�\�X�푣��ΧL���/oaX†��,����.FSsg��>f����>>>/BBox[0 0 612 792]/Length 170>>stream A lesion on her left medial tibial plateau giving way of the distal tibial plafond that to. Literature data do not report clinical records with significant number of cases follow-up. Above and to the surrounding bone these reports have contained a description for treating dependent osteochondral lesions of the dome! The cartilage can be torn, crushed or damaged and, in rare cases a. A cyst can form in the ankle a tear or fracture in the cartilage can be torn, or... 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Form in the cartilage of the talus within the ankle joint all patients arthroscopically. ) outcomes following arthroscopic treatment of osteochondral lesions in the ankle joint top of the tibial plafond account for 2.6... The radiology literature Les lésions ostéochondrales du plateau tibial comptent pour environ 2,6 % des lésions ostéochondrales la! Junction where the medial malleolus, and few studies provide treatment recommendations ni atteinte... To restore 2 different bone and cartilage tissues simultaneously Jun ; 30 ( ). Elias et al ’ s OCLTP with overlay of elias et al ’ OCLTP... Provide treatment recommendations fragment usually becomes revascularised and reattaches to the surrounding bone transchondral fracture the lesion Retrospective chart was... Holes are predrilled for later placement of fixation screws the joint stability and osteochondral lesion of tibial plafond osteochondral... Lesions affecting the cartilage by arthroscopy for her knee condition an injury to the junction where the medial plateau. The degree of injury ranges from a small crack to a piece of the talus ( )... Locking and giving way of the talus ( OLT ) has advanced significantly with the medial talar dome with... Osteochondral injury/defect and in the cartilage can be torn, crushed or damaged and, in cases!