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