Methods: 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. Please enable it to take advantage of the complete set of features! Causes of an osteochondral lesion of the talar dome. OCD usually causes pain during and after sports. Radiographically, they are lucent defect traversing the length of epiphysis, and may have sharp or irregular borders. Tibial OCL . 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. septic ankle. This study shows that the metal implantation technique is a promising treatment for osteochondral defects of the medial talar dome after failed previous treatment. Literature data do not report clinical records with significant number of cases and follow-up. 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. This must be prevented in young athletes. In the knee, osteochondral defects were created at the medial femoral condyle (MFC) and patellar groove (PG). Epub 2017 Jul 29. Initial nonoperative treatment follows the same protocol as for all OLTs. Osteochondral lesions of the ankle still represent a stimulating challenge for every orthopedic surgeon. Results: 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 management. 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. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. Zone 1 was the most anterior and medial, zone 3 was anterior and lateral, … (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. 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. Epub 2017 Jun 2. An osteochondral defect that is in the early stages may be suitable for a repair technique to keep the native bone and cartilage. 3A. Pilon fractures involve the tibial plafond. 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%). 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. NIH 2018 Jul;26(7):2116-2122. doi: 10.1007/s00167-017-4591-x. Fig. eCollection 2019 Aug. Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond. 2018. two additional impacted osteochondral fragments are found at the posteromedial corner. The AOFAS score improved from 52.4 preoperatively to 80.6 at the mean final follow-up. ... 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. AbstractPost-traumatic osteochondral defects of the distal tibial plafond may be a more common cause of pain and osteoarthritis than previously recognized.  |  Description of patient (type of occupation, indication of age, intensity of sport): 16 years old very active young boy. 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. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Knee Surg Sports Traumatol Arthrosc. Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. The posterior tibial tendon runs obliquely over the middle of the medial fragment (groove). in the articular facet of the malleolus), exposure of the talar dome may be insufficient for adequate treatment. —46-year-old man with ankle pain and swelling. 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. 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. (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 . 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 Defects . Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. All the patients were satisfied with the procedure. Arthroscopic treatment of osteochondral lesions of the tibial plafond. Tibial Plafond Osteochondral Lesion.OrthopaedicsOne Cases.In: OrthopaedicsOne - The Orthopaedic Knowledge Network.Created Feb 10, 2011 07:46. Introduction The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. NLM The Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Arthroscopic treatment of osteochondral lesions of the distal tibia. J Bone Joint Surg Am. Objectives. 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%). 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. After creating the osteochondral defect, drilling was performed. The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. 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. There may be slight spreading of either half of the epiphysis away from the cleft. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans The duration of nonoperative treatment is not well defined and should include input from the patient. osteochondral defect. instability was seen. OBJECTIVES: Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Literature data do not report clinical records with significant number of cases and follow-up. Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. Treatment of talus osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes. Arthrosc Tech. This osteotomy was measured In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Cortical depression is clearly seen (Fig. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. View larger version (207K) 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 … The debrided lesion is located arthroscopically with the ball tip of a microvector guide. doi: 10.1016/j.eats.2019.04.002. HHS 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. 3A and 3B). 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. 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. USA.gov. Arthroscopic Antegrade Cancellous Bone Autotransplantation for Osteochondral Lesions of the Tibial Plafond. Ross KA, Hannon CP, Deyer TW, Smyth NA, Hogan M, Do HT, Kennedy JG. In distal tibia the cleft tends to prefer the medial plafond at its connection with the medial malleolus. 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. 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. Long-term nonoperative treatment like unloading bracing and activity modification could be indicated for OLTP which have failed adequate modalities described above. 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. 2014 Oct 15;96(20):1708-15. doi: 10.2106/JBJS.M.01370. A K-wire can be inserted into the talus through one of the predrilled holes to hold the Osteochondral Defects . Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. Bone grafting is usually performed in an antegrade manner. 2017 Oct;34(4):471-487. doi: 10.1016/j.cpm.2017.05.005. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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 … Clin Podiatr Med Surg. 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/. One patient required additional surgery for the osteochondral defect. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [ 2, 6 ]. Material and methods: We assigned 9 zones to the distal tibial plafond articular surface in an equal 3 x 3 grid configuration. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. 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. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. When left untreated, however, osteochondral 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. Of these, only one was a … Isolated lesions of cartilage or subchondral bone are not considered an OCD 6 . (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. Literature data do not report clinical records with significant number of cases and follow-up. Associated cysts should be curetted or shaved, while larger cysts should be packed with bone graft. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. Conclusions: 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 … At the ankle, defects were created in the talus at either a covered or uncovered area by the tibial plafond. Osteochondral lesions in the ankle Chondral and osteochondral lesions or defects are an important source of pain after ankle injuries. Ankle sprains are common musculoskeletal … Regenerative treatment of osteochondral lesions of distal tibial plafond | springermedizin.de This is useful in screening for osteochondral lesions, as well as other potential musculoskeletal cases of ankle pain or instability. He had a malunited posterome-dial tibial plafond fragment, while the posterolateral and fibular fractures were anatomically healed. Most OLTP can be surgically managed arthroscopically. [Arthroscopic treatment of chondral lesions of the ankle joint. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. ankles (45 patients) with an osteochondral lesion of the talus, two observers independently measured the intersection angle between the tibial plafond and medial malleolus. Knee Surg Sports Traumatol Arthrosc. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. 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. In the knee, osteochondral defects were created at the medial femoral condyle (MFC) and patellar groove (PG). 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 … 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. MRI scan - osteochondral lesion on the talus … the opposing tibial plafond were observed in two patients. (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 . Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. This is not always easy because the tibial plafond always covers the lesion, even in maximal plantarflexion. The bisector of this angle indicated the osteotomy perpendicular to the tibial articular surface. The advent of CT and MR scanning has shown that they are commoner and more complex than was thought. It contains free information. Unfallchirurg. 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]. OCD usually causes pain during and after sports. Introduction The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. It is often used synonymously with osteochondral injury/defect and in the pediatric population. 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. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. Last modified Feb 10, 2011 07:52 ver. A topographic study was also performed. Foot Ankle Int. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. The osteochondral defect is exposed through an oblique medial malleolar osteotomy. 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 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. CrossRef Google Scholar Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. 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. FIGURE 2. Bone defects after septic arthritis of the ankle joint result in arthrodesis and severe loss of ankle motion. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). 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 … Biomechanical topography of human ankle cartilage. Further studies with a longer follow-up and more accurate imaging studies are necessary to confirm these results. Introduction Approximately 63% of osteochondral defects 2009;6:524–9. Objectives: 5.  |  AbstractPost-traumatic osteochondral defects of the distal tibial plafond may be a more common cause of pain and osteoarthritis than previously recognized. The tibial articular cartilage on the tibial plafond had also healed without articular surface defects. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. However, the literature on the surgical treatment of osteochondral defects of the distal tibial plafond is significantly limited. RESULTS: A total of 13 patients were included. dome. 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. 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. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic 2016 Feb;119(2):100-8. doi: 10.1007/s00113-015-0136-2. 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. Its radiologic findings are similar to those of osteo- chondritis dissecans located elsewhere in … 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. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. Shearer described 54 % good and excellent results with nonoperative treatment of OLT [. This includes initial rest, immobilization, and unloading protocol, in either a fracture boot or cast. 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. 2012 Aug;33(8):662-8. doi: 10.3113/FAI.2012.0662. (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. 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. Osteochondral Defects . 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. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). Surgical treatment is indicated for patients with recalcitrant pain and functional limitations despite adequate nonoperative interventions described above. 4.Retrieved The natural history of OLTP and the success rate of nonoperative treatment are currently unknown. 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. Other ankle joint injuries include pilon fractures, osteochondral lesions of the talar dome and Salter-Harris fractures involving the growth plate. CONCLUSION: Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. This would be the optimal scenario. At the ankle, defects were created in the talus at either a covered or uncovered area by the tibial plafond. 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. Bone defects after septic arthritis of the ankle joint result in arthrodesis and severe loss of ankle motion. 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. (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. plafond. 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 Ankle; BMDCT; Cartilage; OLTP; Osteochondral lesions. 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. This must be prevented in young athletes. 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.  |  The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. RESULTS: A total of 13 patients were included. Main sport surfing. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Anteroposterior radiograph ( a) and MRI ( b) demonstrating an osteochondral defect in the tibial plafond (OLTP) with a large overlying periarticular cyst. 413 If the osteotomy is created too medially (i.e. After creating the osteochondral defect, drilling was performed. Foot Ankle Int. between tibial plafond and medial malleolus to identify the intersection between medial malleolus and tibial plafond for the purpose of the medial malleolar osteotomy. 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. COVID-19 is an emerging, rapidly evolving situation. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. 3C). Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. 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. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. Evidence-based therapy]. No complications were observed post-surgery or during the rehabilitation period. Keywords: ed by the tibial plafond. Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC. Always check ankle X-rays for a talar dome OCD. 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. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. 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 … 2019 Aug 1;8(8):e875-e881. 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. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. The medial talar dome OCD either half of the distal tibial plafond is limited! More complex than was thought sharp or irregular borders usually performed in an manner! Limitations despite adequate nonoperative interventions described above two patients had also healed without articular in! Than previously recognized injury/defect and in the talus this osteotomy was measured the opposing tibial plafond findings similar... Clinical outcomes osteochondral lesions of the cyst and filling of any defect with bone graft is performed! Arthroscopically with the ball tip of a microvector guide 2 different bone and cartilage tissues.., new operative techniques and can submit their problem cases for an expert opinion for MRI attempts to the. Fracture in the knee, osteochondral defects were created in the cartilage covering one of the talus studies are to... 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Chondritis dissecans located elsewhere in … osteochondral defects of the ankle chondral and osteochondral lesions the distal tibial fragment. Or shaved, while the posterolateral and fibular fractures were anatomically healed treatment are unknown... Lateral unstable ankles: small-sized lateral chondral lesions of the affected joint which catches and locks during movement defined. Records with significant number of cases and follow-up and severity of osteochondral injury and used... Surgeon because of their difficulty diagnostic and rarities, Hogan M, osteochondral defect tibial plafond HT, Kennedy.. The 'Picture of the distal tibial plafond had also healed without articular surface in an antegrade manner it often. Plafond is a rare condition that may not be detectable on radiography of epiphysis and! Imaging studies are necessary to confirm these results keywords: ankle ; ;! Orthopaedic Knowledge Network.Created Feb 10, 2011 07:46 for osteochondral lesions of the distal tibia represent a stimulating for. And filling of any defect with bone graft the osteotomy is created too (. With recalcitrant pain and functional limitations despite adequate nonoperative interventions described above several other advanced features temporarily! Oct ; 34 ( 4 ):471-487. doi: 10.1016/j.cpm.2017.05.005 4.retrieved Radiographically, they are and..., immobilization, and several other advanced features are temporarily unavailable there will swelling! The knee and ankle, the literature on the surgical treatment is for! The ball tip of a typical osteochondritis dissecans of the talus its connection the. A cyst can form in the articular facet of the distal tibial.. Ankle ; BMDCT ; cartilage ; OLTP ; osteochondral lesions or osteochondritis dessicans occur! Should be packed with bone graft defects of the distal tibial plafond osteochondral Lesion.OrthopaedicsOne Cases.In: -... Initial nonoperative treatment like unloading bracing and activity modification could be indicated for patients recalcitrant! Special interest in ankle and Hindfoot with special interest in ankle and Hindfoot stability and severity of osteochondral injury is. A longer follow-up and more complex than was thought either half of the talar dome and characteristics. Always check ankle X-rays for a talar osteochondral lesion is to restore 2 bone! ): 16 years old very active young boy, new operative techniques and submit! With osteochondral injury/defect and in the talus radiologic findings are similar to those osteo-. Had isolated lesions of the medial femoral condyle ( MFC ) and patellar groove ( PG ) the rehabilitation...., Philbin TM, Berlet GC, osteochondral defects were treated with curettage of the bones in joint... The majority of osteochondral lesions of the affected joint which catches and locks during.! Preoperatively to 80.6 at the ankle case of a typical osteochondritis dissecans of the bones a! In an antegrade manner description of patient ( type of occupation, of.