Articular cartilage has poor regenerative capacity, and the osseous blood supply to the talus is tenuous. Osteochondral lesions of the talar dome can cause significant functional impairment and a decreased quality of life. Osteochondral lesions of the talus are commonly associated with a traumatic injury to the ankle joint. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. 11 Chondral injuries generally occur to either the anterolateral or posteromedial ankle. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. They require a strong plan. Osteochondral lesions of the talus encompass a variety of pathological lesions, including osteochondral defects, osteochondritis dissecans, and osteochondral fractures. 2012; 28(12):1902-1907. home--> talar dome fracture osteochondral defect or osteochondritis dessicans WHAT IS A TALAR DOME FRACTURE. The incidence is similar, but lateral talar dome injuries … It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage. 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). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The medial facets of the talar dome articulate with the medial malleolus, and lateral facet with the lateral malleolus. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Talar dome lesions are usually caused by … This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. Talar dome lesions are usually caused by … A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Osteochondral lesions of the talus (OLTs) are a difficult pathologic entity to treat. Talar dome injuries are often missed on initial examination of a routine ankle sprain, only to be diagnosed weeks after the injury. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. 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.A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. A medial talar dome injury is seen on a mortise x-ray view. Lesion size, location, chronicity, and characteristics such as displacement and the presence of subchondral cysts help dictate the appropriate treatment … Much of this bone is covered with cartilage. Kelberine F, Frank A. Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases. The talar dome has no direct muscle attachments(2); during norm… Radiographs showed a suspicious area on the lateral talar dome. A talar osteochondral lesion with a maximal diameter of 15 mm was treated in an arthroscopic fashion using the cartilage taken from the completely displaced osteochondral fragment. 1–3 Two common lesions are notable on the talus. Talar dome lesions are usually caused by … The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. A review of the clinical experience with recombinant human platelet -derived growth factor -BB (rhPDGF-BB) in orthopaedic bone repair and regeneration . Outcome of arthroscopic debridement and microfracture as the primary treatment for osteochondral lesions of the talar dome. Series shows the case of a 25-years-old man, a sports and physically active patient, with chronic ankle pain, a lateral talus osteochondral lesion (OCL), and chronic ankle instability. Medial lesions tend to be deeper and cup shaped. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. • DiGiovanni et al. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. It is also called an osteochondral defect (OCD) or osteochondral lesion 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. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 10. A partial fluid cleft at its posterior margin and a mild subchondral oedema suggests an unstable lesion. Injuries to the talar dome are called talar dome lesions, osteochondral lesions (OLT's), transchondral fractures, osteochondral fractures, bone contusions, or osteochondral defects (OCD's.) OLTs have been known historically by varied nomenclature, including osteochondritis dissecans, talar dome fracture, transchondral fracture, and flake fracture. An osteochondral lesion to the talar dome is an injury that causes damage to the cartilage that sits on top of the talus. OCDs of the talus represent damage to the articular surface of the talar dome in the ankle joint. This allows direct visualization of the articular cartilage of the talar dome without the potential complications of an open arthrotomy. MRI images show a stage IV medial talar dome osteochondral lesion with a minimally displaced osseous fragment corresponding to the plain films. “Osteo” means bone and “chondral” refers to cartilage. 9. onnenwerth MP, Roukis TS. Defined as a separation of articular cartilage from the talar dome, with varying amounts of subchondral bone. Detached osteochondral lesions and loose bodies secondary to osteochondral lesions of the talar dome usually require fragment removal and debridement of the bone bed. The most common cause of a talar lesion is due to an ankle sprain and up to 50 percent of sprains involve some injury to the cartilage. Osteochondral lesions of the talus (OLT) bring the challenges both of articular cartilage healing and a constrained area of access in the ankle joint. Outcomes of talar dome osteochondral defect repair using osteocartilaginous autografts: 37 cases of Mosaicplasty®. “Osteo” means bone and “chondral” refers to cartilage. Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). One of the bones comprising the ankle is the talus bone which forms part of the foot. Patients tend to present with more chronic symptoms of ankle pain, rather than acute injury. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. “Osteo” means bone and “chondral” refers to cartilage. The talus is the bottom bone of the ankle joint. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. 1) and anterolateral (46%) talar dome (1). Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. Mild joint effusion is seen at tibio-talar and subtalar joints. The talus is a bone in the foot that helps form the ankle joint. Osteochondral lesions of the talus (OLTs) have various names and presentations. It forms the “floor” of the ankle joint. “Osteo” means bone and “chondral” refers to cartilage. In general, the edges of the lesion are debrided to healthy, well-attached articular cartilage, and the base of the lesion is abraded to viable, bleeding subchondral bone. Talar dome lesions are usually caused by … Medial osteochondral lesions, however (lesions on the inside part of the talar dome), can be caused either by injury or by chronic weight overload, which can be caused, in part, by very high arches, or by chronic ankle instability. Osteochondral lesion of the talar dome Share | Definition. Elias and colleagues 5 described the exact locations of talar dome OCLs in 424 patients using a nine-zone anatomic grid. An osteochondral lesion of the talus (OLT) is defined as an injury to the talar dome that results in partial or total separation of the articular cartilage or subchondral bone. Talar dome lesions are usually caused by … Injuries to the talar dome should be suspected when an athlete presents with chronic ankle pain following an injury to the ankle. The most common OCLs about the ankle involve the talar dome. Arthroscopy is an important component of treating recalcitrant osteochondral lesions of the talus. The most common sites are the posteromedial (53%) (Fig. 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. In most joints of the foot and ankle, this layer of cartilage is one to a few millimeters thick. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage. An osteochondral injury to the talar dome produces pain at the ankle and you will … These lesions can be chronic in nature, as seen in Osteochondritis Dissecans (OCD). Lesions that appear on the top outside part of the talus are most often caused by injury. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. [ 1] T This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. After the diagnosis is clear from the history, physical examination, and appropriate imaging studies, the treatment plan can be outlined for the patient. FIGURE 71-1 Osteochondral lesion of the talus. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans, and transchondral fracture. Ortho Traumatol: Surg & Research 2015; 101:97- 102. [ 2] A It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Arthroscopy. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Cartilage was cut into chips and combined with bone graft product containing platelet-derived growth factor and a porous collagen scaffold. Arthroscopy. OLTs typically are preceded by a traumatic event and generally result in vascular damage to the subchondral bone. 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