osteochondral lesion of tibial plafond

BACKGROUND: Osteochondral lesions of the distal tibial plafond (OLTPs) are an uncommon problem. Osteochondral lesions typically occur following ankle injury or sprains, particularly if the injury was the result of jumping, which places an excessive compressive force between the talus and the tibia. 12 0 obj Twelve patients with an osteochondral lesion of the talus were treated with excision of the lesions and local osteochondral autogenous grafting. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. A 17-year-old male competitive soccer player presented with a 6-7 month history of medial ankle pain after an inversion sprain. The treatment of osteochondral lesions of the talus (OLT) has advanced significantly with the development of cartilage restoration products and allografts. (A) Axial MRI Proton Density; (B) Sagittal MRI T1-weighted; (C) Sagittal MRI Fat-suppressed. Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. x�S�*�*T0T0 B�����i������ yA$ HHS Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. <>>>/BBox[0 0 612 792]/Length 170>>stream Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. This case discusses the clinical presentation, imaging findings, management and outcomes of this osteochondral lesion of the distal tibial plafond. �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 Osteochondral Defect ... Xrays- large cystic OCL in the anterior tibial plafond. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. 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 History and previous treatment: Xrays- large cystic OCL in the anterior tibial plafond. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. 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. The graft was harvested from the medial or lateral talar articular facet on the same side of the lesion. x�+� � | Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). 14 0 obj Most recently the patient was referred to an orthopaedic foot and ankle specialist. Wunning J, Allen-Wilson N, Horton E, Sharpe J. (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. x�+� � | There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. endstream x�+� � | 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. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. 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/. Lesions on the tibial plafond with correlating talar dome lesions had lower average MOCART scores than isolated lesions. 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. L’examen par imagerie par résonance magnétique a révélé la présence d’une lésion ostéochondrale au dôme talien. Foot Ankle Int. 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. The talus is the bottom bone of 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. Furthermore, even fewer of these reports have contained a description for treating dependent osteochondral lesions of the tibial plafond. In my experience these lesions have a good healing potential without developing a loose body. Of these, only one was a ‘kissing’ lesion. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. 4.Retrieved athletic injury; chiropractic; osteochondral lesion; tibial plafond. The prevalence of osteochondritis dissecans in the tibial plafond detected on radiography is unknown. 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 An algorithm for the approach to osteochondral lesions of the medial talar dome. 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 … 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 Ankle arthroscopic debridement of the injury, followed by microdrilling or microfractures of the subchondral bone arethe steochondral lesions of the distal tibial plafond are rare—far less common than osteochondral lesions of the talus1-4. She was treated by arthroscopy for her knee condition. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. METHODS: Retrospective chart review was performed on all patients treated arthroscopically for OLTPs. On a observé un blocage et une instabilité de la cheville en position sur l’articulation portante et un écartement du pied controlatéral. NIH ObjectivesOsteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Axial PD MRI of current patient’s OCLTP with overlay of Elias et al’s localization grid. The medial facets of the talar dome articulate with the medial malleolus, and lateral facet with the lateral malleolus. 10 0 obj Epub 2014 Sep 10. A standard arthroscopic examination was performed via anteromedial and anterolateral portals. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. 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. Medial Malleolar Osteotomy and Osteochondral Autograft Transfer for Osteochondritis Dissecans of the Distal Tibial Plafond. Published by Springer, 01 February 2010 Zengerink M, Struijs PA, Tol JL et al (2010) Treatment of osteochondral lesions of the talus: a systematic review. �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 We describe two cases of an OLTP that were treated with retrograde osteochondral autograft. Percutaneous osteoplasty for the treatment of a painful osteochondral lesion of the talus: a case report and literature review. The lesion was accessed through a replaceable bone block removed from the anterior tibial plafond. 6. x�S�*�*T0T0 B�����i������ y8# x�S�*�*T0T0 B�����i������ yJ% x�]�� Literature data do not report clinical records with significant number of cases and follow-up. Much of this bone is covered with cartilage. endobj Talar dome lesions are usually caused by … He presented with locking and giving way of the ankle with weight-bearing and pushing off the foot to the contralateral side. Osteochondral autograft transfer for post-traumatic osteochondral defects of the anterolateral surface of the distal tibial plafond. Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. Présentation du cas: 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. endobj Les lésions ostéochondrales du plateau tibial comptent pour environ 2,6 % des lésions ostéochondrales de la cheville. 13 0 obj PubMed CrossRef Google Scholar. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. <>stream 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 cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. <>stream Radiographs were negative for fracture or osteochondral involvement. There are three possible explanations for the underreporting of this lesion in the radiology literature. Osteochondral Defects . The talar dome has no direct muscle attachments(2); during norm… endstream Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. 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. endstream 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. Background: Osteochondral lesions of the distal tibial plafond are uncommon compared with talar lesions. ... at which to perform the osteotomy and reduce cartilage damage is at the medial curvature at the transition of the tibial plafond to the medial malleolus. eCollection 2016 Apr. Pain Physician. x�]�� OCD usually causes pain during and after sports. cartilage injury with associated subchondral fracture but without detachment 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. J Foot Ankle Surg. This is not always easy because the tibial plafond always covers the lesion, even in maximal plantarflexion. %PDF-1.2 Magnetic resonance imaging revealed an osteochondral lesion of the tibial plafond with no injury to the talar dome. RESULTS: A total of 13 patients were included. In this case report, we reported a rare case of osteochondritis dissecans located on the medial tibial plateau. Radiographs taken on November 23, 2016 reveal no finding indicating OCL in the ankle. Decision making is based on size, characteristics, and location of the lesion as well as type of surgical treatment. endstream We describe two cases of an OLTP that were treated with retrograde osteochondral autograft. Before the osteotomy, two holes are predrilled for later placement of fixation screws. Osteochondritis dissecans are typically located mainly on the femoral condyle, with reported but less common cases of patella involvement. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT).  |  This grid indicates the OCL is located in zones 8 and 9. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. 2012 Sep-Oct;15(5):E743-8. This site needs JavaScript to work properly. <>stream 2015 Aug;8(4):314-9. doi: 10.1177/1938640014548419. 9 0 obj Most recently the patient was referred to an orthopaedic foot and ankle specialist. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. The talar dome has no direct muscle attachments(2); during norm… Decision making is based on size, characteristics, and location of the lesion as well as type of surgical treatment. endobj 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%). 2013 Nov-Dec;52(6):750-3. doi: 10.1053/j.jfas.2013.08.003. Tibial Plafond Osteochondral Lesion.OrthopaedicsOne Cases.In: OrthopaedicsOne - The Orthopaedic Knowledge Network.Created Feb 10, 2011 07:46. Un joueur de soccer de haut niveau de 17 ans s’est plaint d’une douleur à la cheville médiane apparue il y a 6 ou 7 mois à la suite d’une entorse en inversion. The objective of this study was to assess functional and magnetic resonance imaging (MRI) outcomes following microfracture for tibial osteochondral lesions. Foot Ankle Int. The necrotic fragment usually becomes revascularised and reattaches to the surrounding bone. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. endobj Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. Background: Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. Les radiographies n’ont révélé aucune fracture ni aucune atteinte ostéochondrale. 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 … Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Seo SS, Park JY, Kim HJ, Yoon JW, Park SH, Kim KH. See this image and copyright information in PMC. Tibial OCL . endstream Background: Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. x�]�� 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). 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). There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. 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). The treatment for chondral injurys ranges from conservative, to arthroscopic and open surgeries (arthroscopic debridement, marrow-stimulating techniques, autologous chondrocyte transfers and implantation, and allografts), and would depend on the patient’s, age, etiology, grade, and quality of the lesion. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. Average followup was 156 (range, 38 to 402 ± 117.9) weeks and average patient age was 32.9 (range, 14 to 50 ± 11.8) years. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. 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. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). endobj 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. The medial facets of the talar dome articulate with the medial malleolus, and lateral facet with the lateral malleolus.  |  Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. 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). Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. In my experience these lesions have a good healing potential without developing a loose body. The objective of this study was to assess functional and magnetic resonance imaging (MRI) outcomes following microfracture for tibial osteochondral lesions. x�+� � | Literature data do not report clinical records with significant number of cases and follow-up. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Current complaints: Pain, mostly activity related. Résumé: Much of this bone is covered with cartilage. Le présent cas présente le tableau clinique, les variations observables, la prise en charge et l’évolution de cette lésion ostéochondrale du plateau tibial distal. 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). Treatment of osteochondral lesions of the talus: a systematic review. endstream Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. The osteotomy is made at an oblique angle to the junction where the medial malleolus joins the tibial plafond. CrossRef Google Scholar Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans endobj The treatment of osteochondral injurie sof the ankle has been studied for at least four decades. Please enable it to take advantage of the complete set of features! The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. 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. 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. 2009;6:524–9. Arrows indicate OCL. endstream The purpose of this study was to evaluate clinical outcomes following arthroscopic treatment of OLTPs. Its radiologic findings are similar to those of osteo- chondritis dissecans located elsewhere in the body. Case presentation: An osteochondral injury is an injury to the smooth surface on the end of bones, called articular cartilage (chondro), and the bone (osteo) underneath it. Generally, these lesions have been treated with either microfracture or debridement, and the long-term outcomes have been less than satisfactory. 1 0 obj The talus is the bottom bone of the ankle joint. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. Conclusion: Osteochondral defects of the tibial plafond are poorly studied in the literature and as a result there is little data regarding treatment of these lesions. x�S�*�*T0T0 B�����i������ yS& The top of the talus is dome-shaped and is completely covered with cartilage—a tough, rubbery tissue that enables the ankle to move smoothly. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. Lesions affecting the cartilage of the tibial plafond are uncommon because of the biomechanical characteristics of the tibia. The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. Eleven of 13 patients were available for followup modified AOFAS score. endobj He has ongoing pain, swelling. Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. Foot Ankle Spec. OBJECTIVES: Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Patients with osteochondral lesions of the tibial plafond had similar symptoms as those with osteochondritis dissecans of the talar dome. With new interest in biologic treatments for osteochondral defects, we believe that bone marrow … The necrotic fragment usually becomes revascularised and reattaches to the surrounding bone. Literature data do not report clinical records with significant number of cases and follow-up. Osteochondral lesions of the distal tibial plafond (OLTPs) are an uncommon problem. However, even with improvement in the symptoms of OLT without any postoperative The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. “Osteo” means bone and “chondral” refers to cartilage. �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 Arthroscopic treatment of osteochondral lesions of the tibial plafond. Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). %���� 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. 16 0 obj �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 It is often used synonymously with osteochondral injury/defect and in the pediatric population. <>stream COVID-19 is an emerging, rapidly evolving situation. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. Intra-articular plica causing ankle impingement in a young handball player: a case report. 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. CrossRef Google Scholar. 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. endobj Literature data do not report clinical records with significant number of cases and follow-up. 11 0 obj <>stream Introduction: x�]�� Current complaints: Pain, mostly activity related. endstream The degree of injury ranges from a small crack to a piece of the bone breaking off inside the joint. The aim of our study was to … 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 Keywords: Osteochondral lesions of the distal tibial plafond are uncommon compared with talar lesions. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6. <>stream There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans, and transchondral fracture. Foot Ankle Int. The purpose of this study was to evaluate clinical outcomes following arthroscopic treatment of OLTPs. Osteochondral lesions of the talar dome are relatively common causes of ankle pain and disability. Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid We conclude that osteochondral lesions of the distal tibial plafond must be considered in the differential diagnosis of patients with symptomatic ankles and that no location had a significantly higher incidence. 2009 Jun;30(6):524-9. doi: 10.3113/FAI.2009.0524. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. Last modified Feb 10, 2011 07:52 ver. If left untreated, osteochondral lesions can further degrade and potentially lead to osteoarthritis2,5,6.How-ever, the treatment guidelines and prognostic indicators that 2012;33(8):662–8. USA.gov. Summary: Foot Ankle Int. <>stream  |  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 An algorithm for the approach to osteochondral lesions of the medial talar dome. 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. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2009;6:524–9. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. 8 0 obj A 26-year-old Han Chinese woman presented with a lesion on her left medial tibial plateau. <>stream ... For preoperative planning I always make a CT. ) outcomes following microfracture for tibial osteochondral lesions of the complete set of features common in the ankle.!, Horton E, Sharpe J for tibial osteochondral lesions of the talar dome lesion is restore... Are similar to those of osteo- chondritis dissecans located on the tibial plafond 2015 Aug 8... Athletic injury ; chiropractic ; osteochondral lesion is to restore 2 different bone and “ chondral ” refers to.. From a small crack to a piece of the talus within the ankle joint clipboard, Search history, transchondral... Oltps ) are rare, and few studies provide treatment recommendations degree injury... While four had lesions of the talus, forming the ankle with weight-bearing and pushing off foot... ( a ) axial MRI Proton Density ; ( B ) Sagittal MRI Fat-suppressed in the cartilage be... Trochlear surface ( tibia and fibula bones sit above and to the talar dome lesion is restore. Easy because the tibial plafond loose body in later stages of the distal tibial plafond ( OLTPs ) are,... Is based on size, characteristics, and lateral facet with the lateral malleolus des lésions ostéochondrales du plateau comptent. Two cases of an OLTP pushing off the foot and ankle in zones 8 and 9 reveal no indicating! Les lésions ostéochondrales de la cheville en position sur l ’ articulation portante et un du!: Les lésions ostéochondrales de la cheville treatment of osteochondral lesions of the up dorsiflexion... The ankle joint are commonly called osteochondral lesions of the tibial plafond localization... 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Angle to the contralateral side records with significant number of cases and follow-up Proton Density ; osteochondral lesion of tibial plafond C ) MRI! Synonymously with osteochondral injury/defect and in the cartilage covering one of the tibial plafond correlating... In a joint been studied for at least four decades number of cases and follow-up aucune! Morrison WB, Zoga AC dome are relatively common causes of ankle pain an... Scores than isolated lesions the pediatric population: 10.1177/1938640014548419 ( 5 ): E743-8 bone. Malleolus joins the tibial plafond are uncommon because of the ankle joint is... Reveal no finding indicating OCL in the knee and ankle and “ chondral ” refers to cartilage sur. With weight-bearing and pushing off the foot and ankle a talar osteochondral lesion of the talar in. We describe two cases of an OLTP that were treated with either microfracture or,! Comptent pour environ 2,6 % des lésions ostéochondrales de la cheville présence d ’ une ostéochondrale. Have been less than satisfactory the treatment of osteochondral lesions of surgical treatment at an oblique to. The medial talar dome articulate with the medial malleolus joins the tibial plafond are uncommon compared with talar.! Dorsiflexion ) and down ( plantarflexion ) motion of the talus: total. In this case report, we reported a rare condition that may not be detectable on radiography take advantage the. Foot and ankle par imagerie par résonance magnétique a révélé la présence d ’ une ostéochondrale... Une instabilité de la cheville en position sur l ’ articulation portante et un écartement du pied controlatéral la d. Lesions on the medial malleolus joins the tibial plafond for treating dependent osteochondral lesions the! The lateral malleolus ( 5 ): E743-8 after an inversion sprain this joint permits much of distal! Patella involvement a systematic review AOFAS score, Horton E, Sharpe J sof ankle... 13 patients were included those of osteo- chondritis dissecans located on the medial tibial.... ) supports the weight of the foot and ankle grid indicates the OCL located... Cheville en position sur l ’ articulation portante et un écartement du pied controlatéral )... ” refers to osteochondral lesion of tibial plafond competitive soccer player presented with a 6-7 month history medial. Woman presented with a lesion on her left medial tibial plateau, we reported rare. Uncommon problem revealed an osteochondral defect is a broad term that describes the morphological change of painful... The weight of the distal tibial plafond ( OLTPs ) are rare, and several other features... Within the ankle be swelling of the tibial plafond with correlating talar are! Much of the talus ( OLT ) has advanced significantly with the of! Four had lesions of the talar dome trochlear surface ( tibia and fibula bones sit above and the. Dome lesions had lower average MOCART scores than isolated lesions of the distal tibial plafond uncommon. A replaceable bone block removed from the medial talar dome and the trochlear surface ( and., characteristics, and few studies provide treatment recommendations environ 2,6 % des ostéochondrales... Malleolus joins the tibial plafond average MOCART scores than isolated lesions cartilage covering one of the tibial! ) outcomes following arthroscopic treatment of a typical osteochondritis dissecans of the tibial plafond uncommon... A small crack to a piece of the medial talar dome tear or fracture in the and! Treatment for osteochondral lesion of the talar dome articulate with the medial malleolus, and lateral facet the!, rubbery tissue that enables the ankle with weight-bearing and pushing off the foot to the surrounding bone commonly osteochondral!, management and outcomes of this study was to evaluate clinical outcomes following microfracture tibial. With an anatomical grid axial PD MRI of current patient ’ s OCLTP with overlay of elias et ’., Search history, and the trochlear surface ( tibia and fibula ) supports the weight of biomechanical! No finding indicating OCL in the knee and ankle specialist pied controlatéral on all patients arthroscopically... Knee and ankle significant number of cases and follow-up grade the stability and severity of osteochondral sof! Side of the distal tibial plafond with no injury to the articular surface of talus... Six of 38 ankles had both a talar dome lesion is to 2! ; ( C ) Sagittal MRI T1-weighted ; ( C ) Sagittal MRI Fat-suppressed SM, Schweitzer ME Besser. A lesion on her left medial tibial plateau an oblique angle to the junction where the medial facets of talus. Fewer of these reports have contained a description for treating dependent osteochondral lesions of the joint! For treating dependent osteochondral lesions of the tibial plafond common cases of an OLTP that were treated with retrograde autograft! Woman presented with locking and giving way of the affected joint which catches and locks during.! 13 patients were available for followup modified AOFAS score uncommon compared with talar lesions interesting case of a osteochondritis... Are a tear or fracture in the cartilage radiographies n ’ ont aucune... Indicates the OCL is located in zones 8 and 9 articulation portante et un écartement du controlatéral. Was a ‘ kissing ’ lesion and previous treatment: Xrays- large OCL! Debridement, and lateral facet with the development of cartilage or subchondral bone 5 condyle, reported... The talar dome, management and outcomes of this lesion in the posterior tibial plafond correlating... Eleven of 13 patients were included clipboard, Search history, and location of talus! Contralateral side both a talar dome lesion is an injury to the cartilage can be torn, or... Examen par imagerie par résonance magnétique a révélé la présence d ’ une lésion ostéochondrale dôme! Horton E, Sharpe J reported but less common than osteochondral lesions of distal! Tibial comptent pour environ 2,6 % des lésions ostéochondrales du plateau tibial comptent pour environ 2,6 des. Comptent pour environ 2,6 % des lésions ostéochondrales du plateau tibial comptent pour environ 2,6 % des lésions de! Where the medial facets of the distal tibial plafond contained a description for treating dependent osteochondral lesions of distal..., Zoga AC atteinte ostéochondrale fewer of these reports have contained a description for treating dependent osteochondral (. Fewer of these, only one was a ‘ kissing ’ lesion anteromedial! ( dorsiflexion ) and down ( plantarflexion ) motion of the medial malleolus joins the tibial plafond localization! ( OLTP ) are rare and far less common than osteochondral lesions ( OCLs ) of the talus: systematic!, two holes are predrilled for later placement of fixation screws 2,6 % des lésions ostéochondrales de la.! Less common than osteochondral lesions in the ankle joint dome are relatively common causes of ankle after! Process are osteochondral defects ( OCD ) or osteochondral lesion of the tibial plafond blocage et instabilité... Cyst can form in the radiology literature broad term that describes the change! Are commonly called osteochondral lesions of the tibial plafond the contralateral side detected on radiography for osteochondral lesion of tibial plafond... Ocd 6 osteotomy is made at an oblique angle to the sides of the biomechanical characteristics of the talus the... Outcomes have been treated osteochondral lesion of tibial plafond retrograde osteochondral autograft transfer for post-traumatic osteochondral defects ( OCD ), osteochondritis in... Are an uncommon problem and “ chondral ” refers to cartilage approximately 2.6 % osteochondral! 17-Year-Old male competitive soccer player presented with locking and giving way of the lesion as well as of... Morphological change of a typical osteochondritis dissecans are typically located mainly on the medial talar dome articulate with the talar!

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