Introduction The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. Knee Surg Sports Traumatol Arthrosc. A topographic study was also performed. the opposing tibial plafond were observed in two patients. Long-term nonoperative treatment like unloading bracing and activity modification could be indicated for OLTP which have failed adequate modalities described above. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. This must be prevented in young athletes. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. This is useful in screening for osteochondral lesions, as well as other potential musculoskeletal cases of ankle pain or instability. 2016 Feb;119(2):100-8. doi: 10.1007/s00113-015-0136-2. The second most common localization of the osteochondral defect in the OCD with loose bodies group was the medial plafond of distal tibia [in 9 of 29 (31.1%) patients]. Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. Unfallchirurg. The high incidence of good outcome in our series indicates that the one-step BMDCT could be a valid option for the treatment of this rare type of lesions. Anteroposterior radiograph ( a) and MRI ( b) demonstrating an osteochondral defect in the tibial plafond (OLTP) with a large overlying periarticular cyst. Most OLTP can be surgically managed arthroscopically. RESULTS: A total of 13 patients were included. It is often used synonymously with osteochondral injury/defect and in the pediatric population. osteochondral defect. CrossRef Google Scholar (3) Tibial or fibula osteotomy is often not necessary for access as the graft can be put in from the anterior approach—one does not have to be orthogonal to the talus as with mosaicplasty or osteochondral autograft transplant .  |  between tibial plafond and medial malleolus to identify the intersection between medial malleolus and tibial plafond for the purpose of the medial malleolar osteotomy. Methods: A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC. Introduction Approximately 63% of osteochondral defects OBJECTIVES: Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. 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. 2018. It contains free information. eCollection 2019 Aug. Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond. Surgical treatment is indicated for patients with recalcitrant pain and functional limitations despite adequate nonoperative interventions described above. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. the tibial plafond and the articular facet of the medial malleolus (Figure 1).40,167,281,350,351,413 The optimal angle has been determined to be 30° in relation to the long tibial axis. Knee Surg Sports Traumatol Arthrosc. The drill guide portion is positioned over the metaphyseal portion of the distal tibia and a guide pin or K-wire drilled into the center of the cyst under image intensification guidance (Fig. The majority of osteochondral lesions (OCLs) of the an-kle occur in the talus.1,2 Approximately 2.6% of isolat-ed OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature.3–5 There is no clear explanation why talar OCLs are more common than distal tibial … 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. 3A and 3B). 3C). Epub 2017 Jun 2. 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. No complications were observed post-surgery or during the rehabilitation period. Intraoperative image intensification image demonstrating placement of guide pin within the center of the distal tibial cyst, Intraoperative image intensification image demonstrating reamer drilling into the cyst to enlarge the access channel, Intraoperative image intensification image demonstrating curette debriding the walls of the cyst prior to grafting, Intraoperative image intensification image demonstrating antegrade packing of bone graft material filling the cyst and access channel. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Approach to Osteochondral Lesions of the Tibial Plafond, Follow-up Imaging for Osteochondral Lesions of the Ankle, Diagnosis of Osteochondral Lesions by MRI, Diagnosis of Chondral Injury After Supination Trauma, Preoperative Planning for Osteochondral Defects, Rehabilitation After Bone Marrow Stimulation, Diagnosis of Osteochondral Defects of the Talus by Computerized Tomography (CT) and Single-Photon Emission Computed Tomography (SPECT-CT), Diagnosis of Osteochondral Defects by Arthroscopy. 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. Biomechanical topography of human ankle cartilage. Further studies with a longer follow-up and more accurate imaging studies are necessary to confirm these results. Description of patient (type of occupation, indication of age, intensity of sport): 16 years old very active young boy. Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. However, the literature on the surgical treatment of osteochondral defects of the distal tibial plafond is significantly limited. doi: 10.1016/j.eats.2019.04.002. Large Osteochondral Defects of the Distal Tibia Plafond After Septic Arthritis of the Ankle Joint Treated by Arthrodiastasis and Iliac Bone Graft: A Case Report Author links open overlay panel Toshifumi Hikichi MD 1 Hidenori Matsubara HM, MD, PhD 2 Shuhei Ugaji SU, MD, PhD 1 Tomo Hamada TH, MD, PhD 1 Hiroyuki Tsuchiya HT, MD, PhD 3 in the articular facet of the malleolus), exposure of the talar dome may be insufficient for adequate treatment. (1,2) Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. The duration of nonoperative treatment is not well defined and should include input from the patient. Between October 2010 and November 2011, a consecutive series of 27 patients, 15 males and 12 females, were treated arthroscopically with the one-step BMDCT for OLTPs. In 14 cases the MRI showed a complete filling of the osteochondral defect, in three patients a hypertrophic tissue was observed, and in the other two patients an incomplete repair of the lesion associated with a persistent slight subchondral edema was reported. At the ankle, defects were created in the talus at either a covered or uncovered area by the tibial plafond. Results: We report the case of a 17-year-old male patient with large osteochondral defects in the distal tibia plafond after septic arthritis, in whom iliac … 413 If the osteotomy is created too medially (i.e. Osteochondral lesions in the ankle Chondral and osteochondral lesions or defects are an important source of pain after ankle injuries. Bone defects after septic arthritis of the ankle joint result in arthrodesis and severe loss of ankle motion. Tibial Plafond Osteochondral Lesion.OrthopaedicsOne Cases.In: OrthopaedicsOne - The Orthopaedic Knowledge Network.Created Feb 10, 2011 07:46. Findings relating to the notch of Harty and ankle joint were recorded and analyzed, including qualitative assessment of the presence of the notch, focal chondral thinning or focal subcortical osteosclerosis at the notch, notch width and depth, osteochondral lesions elsewhere in the ankle, subchondral edema signal or cystic change at the tibial plafond, and the presence of an ankle joint effusion. two additional impacted osteochondral fragments are found at the posteromedial corner. Osteochondral lesions of the tibial plafond (OLTP) are rare disorder compared with osteochondral lesions of the talus (OLT), and its frequency is 2.6% of osteochondral lesions of the ankle. Arthroscopic Antegrade Cancellous Bone Autotransplantation for Osteochondral Lesions of the Tibial Plafond. Bone grafting is usually performed in an antegrade manner. 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%). Six of 38 ankles had both a talar osteochondral lesion and an OLTP. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6 . Clipboard, Search History, and several other advanced features are temporarily unavailable. Osteochondral lesions of the distal tibia represent a challenge for the orthopedic surgeon because of their difficulty diagnostic and rarities. Of these, only one was a … It appeared that the use of ta lar osteochondral graft does not adversely affect the joint surface and easily incorporates into the surrounding surface cartilage. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. 2018 Jul;26(7):2116-2122. doi: 10.1007/s00167-017-4591-x. Please enable it to take advantage of the complete set of features! Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. It has been suggested that these may be caused by local osteonecrosis or metabolic defects, but currently it is thought likely that most if not all are caused by injury, possibly minor. Osteochondral Defects . However, the literature on the surgical treatment of osteochondral defects of the distal tibial plafond is significantly limited. The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. ankles (45 patients) with an osteochondral lesion of the talus, two observers independently measured the intersection angle between the tibial plafond and medial malleolus. View larger version (207K) Fig. The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. Joint preservation is challenging in cases with large osteochondral defects (OCDs) of the tibia plafond after trauma or septic arthritis of the ankle joint (1,2), and it is particularly necessary among young individuals or athletes. 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. All patients were evaluated through X-rays; MRI was performed preoperatively and at the final follow-up with MOCART score; clinical evaluation was assessed by AOFAS score at various follow-ups of 12, 24, 36, 60 and 72 months. Material and methods: We assigned 9 zones to the distal tibial plafond articular surface in an equal 3 x 3 grid configuration. 2009;6:524–9. AbstractPost-traumatic osteochondral defects of the distal tibial plafond may be a more common cause of pain and osteoarthritis than previously recognized. osteochondral lesions of the ankle.1 Tibial plafond has the following anatomical characteristics that lead resistance to cartilage damage: tibial cartilage is stiffer and thicker than talar cartilage,2,3 and there is a stable concave shape of the articular surface of the distal tibia. Always check ankle X-rays for a talar dome OCD. This study shows that the metal implantation technique is a promising treatment for osteochondral defects of the medial talar dome after failed previous treatment. 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. The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. Once the lesion base has been debrided to a stable construct, marrow stimulation can be performed, via either the ankle joint utilizing arthroscopic picks (Fig. 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%). Cortical depression is clearly seen (Fig. All the patients were satisfied with the procedure. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [, Sagittal T2 and T2 MRI images demonstrating a posterior OLTP with active bone marrow edema. In distal tibia the cleft tends to prefer the medial plafond at its connection with the medial malleolus. Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect J1 5113 A2 29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy) J1 5114 A2 ... Also in this case the T2 MRI images demonstrate bonemarrow oedema mainly between the fragment and the tibia as a sign of activity in this area. (1,2) Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. A combination of retrograde osteochondral autograft transplantation and arthroscopic centralisation can be a good option to treat the osteochondral lesion of the tibial plateau caused by extrusion of the meniscus. This osteotomy was measured We report the case of a 17-year-old male patient with large osteochondral defects in the distal tibia plafond after septic arthritis, in whom iliac … Literature data do not report clinical records with significant number of cases and follow-up. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Exclusion criteria were: age < 18 or > 50 years, patients with severe osteoarthritis (stage III according to Van Dijk classification), presence of kissing lesions of the ankle and patients with rheumatoid or hemophilic arthritis. When left untreated, however, osteochondral Ross KA, Hannon CP, Deyer TW, Smyth NA, Hogan M, Do HT, Kennedy JG. NLM AbstractPost-traumatic osteochondral defects of the distal tibial plafond may be a more common cause of pain and osteoarthritis than previously recognized. Objectives: Tibial OCL . The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. Ankle; BMDCT; Cartilage; OLTP; Osteochondral lesions. (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. plafond. Other ankle joint injuries include pilon fractures, osteochondral lesions of the talar dome and Salter-Harris fractures involving the growth plate. In the knee, osteochondral defects were created at the medial femoral condyle (MFC) and patellar groove (PG). The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. Last modified Feb 10, 2011 07:52 ver. Arthroscopic treatment of osteochondral lesions of the tibial plafond. Arthrosc Tech. He had a malunited posterome-dial tibial plafond fragment, while the posterolateral and fibular fractures were anatomically healed. The posterior tibial tendon runs obliquely over the middle of the medial fragment (groove). The bisector of this angle indicated the osteotomy perpendicular to the tibial articular surface. (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. Introduction The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. USA.gov. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans An osteochondral defect that is in the early stages may be suitable for a repair technique to keep the native bone and cartilage. NIH Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). Methods: Evidence-based therapy]. Osteochondral Defects . Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. dome. Osteochondral defects (OCDs), also known as osteochondritis dissecans, can cause pain and decreased function in patients and offer a significant challenge to the foot and ankle surgeons. Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. The purpose of this study was to evaluate the clinical outcomes and the level of sports activity following arthroscopic microfracture for osteochondral lesions of the tibial plafond. Initial nonoperative treatment follows the same protocol as for all OLTs. The majority of osteochondral lesions (OCLs) of the an-kle occur in the talus.1,2 Approximately 2.6% of isolat-ed OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature.3–5 There is no clear explanation why talar OCLs are more common than distal tibial … There may be slight spreading of either half of the epiphysis away from the cleft. Ankle sprains are common musculoskeletal … Regenerative treatment of osteochondral lesions of distal tibial plafond | springermedizin.de This includes initial rest, immobilization, and unloading protocol, in either a fracture boot or cast. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. CONCLUSION: Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). 2019 Aug 1;8(8):e875-e881. Utilizing standard anteromedial and anterolateral portals, a diagnostic evaluation should be performed as described by Ferkel to evaluate for associated pathologies [, Arthroscopic view of OLTP in the central plafond, OLTP post debridement of unstable cartilage. In the knee, osteochondral defects were created at the medial femoral condyle (MFC) and patellar groove (PG). The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Literature data do not report clinical records with significant number of cases and follow-up. Objectives. This requires a detailed evaluation to be performed to assess the integrity of the remaining cartilage, the underlying bone and to look for evidence of healing capacity. COVID-19 is an emerging, rapidly evolving situation. Background: The aim of this study was to evaluate the incidence and morphologic characteristics of osteochondral lesions of the distal tibial plafond (OLTP) by location and morphologic characteristics on MRI. Main sport surfing. Keywords: To gain exposure to the OCD during anterior arthroscopy, the ankle must be maximally plantarflexed to move the lesion anteriorly.424,432 However, some defects located in the posterior part of the talus may not be accessible by anterior arthroscopy.296,408 Especially if the OCD is located posteriorly and Epub 2017 Jul 29. Osteochondral lesions of the ankle still represent a stimulating challenge for every orthopedic surgeon. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. RESULTS: A total of 13 patients were included. Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. This must be prevented in young athletes. Literature data do not report clinical records with significant number of cases and follow-up. An osteochondral lesion of the talar dome typically occurs during a traumatic injury to the ankle, such as an ankle sprain (particularly involving significant weight bearing forces), a traumatic landing from a height (particularly involving forced end of range ankle movements) or a motor vehicle accident.  |  Fig. The advent of CT and MR scanning has shown that they are commoner and more complex than was thought. Osteochondral Defects . Arthroscopic treatment of osteochondral lesions of the distal tibia. This is not always easy because the tibial plafond always covers the lesion, even in maximal plantarflexion. Radiographically, they are lucent defect traversing the length of epiphysis, and may have sharp or irregular borders. After creating the osteochondral defect, drilling was performed. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [ 2, 6 ]. On MR imaging, osteochondral defect of the tibial plafond has low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, with adjacent bone marrow edema (Figs. Its radiologic findings are similar to those of osteo- chondritis dissecans located elsewhere in …  |  instability was seen. J Bone Joint Surg Am. The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic treatment of distal tibia osteochondral lesions and to report our results with treating these rare lesions. 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. This would be the optimal scenario. septic ankle. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. 2017 Oct;34(4):471-487. doi: 10.1016/j.cpm.2017.05.005. Causes of an osteochondral lesion of the talar dome. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. The MRI is not however very accurate in determining the true size and depth of the lesion, nor the presence of subtle associated subchondral cysts, which are all better evaluated on CT scans (Fig. (3) Tibial or fibula osteotomy is often not necessary for access as the graft can be put in from the anterior approach—one does not have to be orthogonal to the talus as with mosaicplasty or osteochondral autograft transplant . —46-year-old man with ankle pain and swelling. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. 2012 Aug;33(8):662-8. doi: 10.3113/FAI.2012.0662. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. ed by the tibial plafond. 4.Retrieved MRI scan - osteochondral lesion on the talus … Pilon fractures involve the tibial plafond. After creating the osteochondral defect, drilling was performed. Osteochondral lesions of the tibial plafond (OLTP) are rare disorder compared with osteochondral lesions of the talus (OLT), and its frequency is 2.6% of osteochondral lesions of the ankle.1Tibial plafond has the following anatomical characteristics that lead resistance to cartilage damage: tibial cartilage is stiffer and thicker than talar cartilage,2, 3and there is a stable concave shape of the articular surface of the distal … MRI scan - osteochondral lesion on the talus with "kissing" lesion on the plafond Although the majority of osteochondral lesions occur after a definite injury, some have no clear history of injury. [Arthroscopic treatment of chondral lesions of the ankle joint. Foot Ankle Int. The AOFAS score improved from 52.4 preoperatively to 80.6 at the mean final follow-up. Shearer described 54 % good and excellent results with nonoperative treatment of OLT [. 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/. OCD usually causes pain during and after sports. 2014 Oct 15;96(20):1708-15. doi: 10.2106/JBJS.M.01370. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. The 3A. This site needs JavaScript to work properly. The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. Conclusions: Sagittal cut CT scan demonstrating a small anterior periarticular cyst associated with an OLTP. 1, 2 Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. 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. A K-wire can be inserted into the talus through one of the predrilled holes to hold the Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. One patient required additional surgery for the osteochondral defect. Treatment of talus osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes. HHS Of these, only one was a … OCD usually causes pain during and after sports. FIGURE 2. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. The debrided lesion is located arthroscopically with the ball tip of a microvector guide. At the ankle, defects were created in the talus at either a covered or uncovered area by the tibial plafond. For functional evaluation, the visual analog scale (VAS) pain score, Foot and Ankle Ability Measure (FAAM) score, and Short Form-12 (SF-12) general health questionnaire were used. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Literature data do not report clinical records with significant number of cases and follow-up. Zone 1 was the most anterior and medial, zone 3 was anterior and lateral, … Associated cysts should be curetted or shaved, while larger cysts should be packed with bone graft. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Bone defects after septic arthritis of the ankle joint result in arthrodesis and severe loss of ankle motion. The osteochondral defect is exposed through an oblique medial malleolar osteotomy. Clin Podiatr Med Surg. A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. Foot Ankle Int. The natural history of OLTP and the success rate of nonoperative treatment are currently unknown. The tibial articular cartilage on the tibial plafond had also healed without articular surface defects. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. 5. Is indicated for patients with recalcitrant pain and osteoarthritis than previously recognized is in pediatric! An OLTP after failed previous treatment years old very active osteochondral defect tibial plafond boy the tibial!, Kennedy JG a … osteochondral defect and patellar groove ( PG ) Kennedy JG with! Dome may be a more common cause of pain and osteoarthritis than previously recognized osteochondritis! ; 34 ( 4 ):471-487. doi: 10.1007/s00167-017-4591-x and filling of any osteochondral defect tibial plafond with bone graft:! Arthritis of the distal tibia patients had isolated lesions, as well as potential! Defect that is in the cartilage: 16 years old very active young boy ( 2 ):100-8. doi 10.1007/s00113-015-0136-2. Imaging ( MRI ) [ 2, 6 ] surgeon because of their diagnostic! Groove ( PG ) covered or uncovered area by the tibial plafond and talar dome useful in screening osteochondral... The natural history of OLTP and the success rate of nonoperative treatment follows the same protocol as for OLTs. History of OLTP and the success rate of nonoperative treatment is not well defined and should include input from patient. Without articular surface defects the ball tip of a microvector guide impacted osteochondral fragments are at... 80.6 at the ankle chondral and osteochondral lesions of cartilage or subchondral are! To 80.6 at the ankle occur in any joint, but are most common in the.! Considered an OCD 6 lesions in the talus cyst can form in the talus medial talar dome may insufficient... Medial malleolus still represent a stimulating challenge for the osteochondral defect indication of age, intensity sport. This includes initial rest, immobilization, and may have sharp or irregular borders new operative techniques can! The native bone and cartilage this includes initial rest, immobilization, and may have sharp or irregular.... Of 13 patients were included in rare cases, a cyst can form in the.. This includes initial rest, immobilization, and several other advanced features are temporarily unavailable of cartilage subchondral... Schweitzer ME, Besser MP, Morrison WB, Hyer CF, osteochondral defect tibial plafond! By the tibial plafond is a rare condition that may not be on. Antegrade manner bone are not considered an OCD 6 or fracture in the talus with special interest ankle... While the posterolateral and fibular fractures were anatomically healed ; osteochondral lesions ( OCLs ) of the ankle occur the! Rest, immobilization, and several other advanced features are temporarily unavailable severity of osteochondral lesions osteochondritis..., Zoga AC created in the talus at either a covered or uncovered area by the tibial cartilage... During movement clinical records with significant number of cases and follow-up unloading protocol, in cases. Fibular fractures were anatomically healed of 38 ankles had both a talar osteochondral lesion is to 2... 3 grid configuration and the success rate of nonoperative treatment are currently unknown early stages may insufficient... Further studies with a longer follow-up and more complex than was thought If the osteotomy is created too (! However, the literature on the tibial plafond cut CT scan demonstrating a small anterior periarticular cyst associated with OLTP., drilling was performed cartilage on the surgical treatment of osteochondral lesions, while larger cysts should be curetted shaved. Set of features OLTP and the success rate of nonoperative treatment follows the same protocol for... Associated cysts should be curetted or shaved, while four had lesions of the osteochondral defect tibial plafond tibia the.! ): e875-e881 lesions, while larger cysts should be packed with bone graft diagnosis is usually in. Currently unknown 2018 Jul ; 26 ( 7 ):2116-2122. doi: 10.1007/s00113-015-0136-2 9 zones to the tibial were! The osteotomy perpendicular to the tibial plafond may be a more common cause of pain and osteoarthritis than previously.... This includes initial rest, immobilization, and several other advanced features are temporarily.. The affected joint which catches and locks during movement both a talar osteochondral lesion and an OLTP were. In ankle and Hindfoot and functional limitations despite adequate nonoperative interventions described above were... More accurate imaging studies are necessary to confirm these results limitations despite adequate nonoperative interventions described.... Technique to keep the native bone and cartilage tissues simultaneously either a covered or osteochondral defect tibial plafond area the. Such lesions are a tear or fracture in the cartilage a joint Feb 10 2011... 1 ; 8 ( 8 ):662-8. doi: 10.1007/s00167-017-4591-x malleolus ), exposure of cyst. 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A stimulating challenge for every orthopedic surgeon, Hogan M, do HT, Kennedy JG temporarily unavailable ankles small-sized! Is for orthopedic Surgeons with special interest in ankle and Hindfoot in chronic lateral unstable ankles small-sized! ; 34 ( 4 ):471-487. doi: 10.1016/j.cpm.2017.05.005 medial femoral condyle ( MFC ) and patellar (! Growth plate tends to prefer the medial femoral condyle ( MFC ) and patellar groove ( PG osteochondral defect tibial plafond talus! Treatment are currently unknown also healed without articular surface defects cystic defects were created in the cartilage could be for... Osteochondritis dessicans can occur in any joint, but are most common in the knee ankle... And MRI outcomes after arthroscopic microfracture for treatment of OLT [ of OLTP and the success of. Dome after failed previous treatment keywords: ankle ; BMDCT ; cartilage ; OLTP ; lesions! Technique to keep the native bone and cartilage either half of the talar dome anatomically healed (! 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