[Osteochondral lesions of the talus : Individualized approach based on established and innovative reconstruction techniques].
Osteochondrale Läsionen des Talus : Individualisiertes Vorgehen mithilfe etablierter und innovativer Rekonstruktionsverfahren.
Ankle injury
Arthroscopy
Cartilage defect
Conservative therapy
Reconstructive procedures
Journal
Der Unfallchirurg
ISSN: 1433-044X
Titre abrégé: Unfallchirurg
Pays: Germany
ID NLM: 8502736
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
accepted:
27
01
2021
pubmed:
6
3
2021
medline:
25
3
2021
entrez:
5
3
2021
Statut:
ppublish
Résumé
Osteochondral lesions (OCL) of the talus are defined as chondral damage with subchondral involvement. The traumatic etiology is important; in particular, sprains and fractures can lead to lesions of the articular surface and the subchondral plate. As a result, unstable lesions and subchondral cysts can trigger substantial persistent pain and functional impairments. A primary conservative treatment can be considered and is especially recommended in children and adolescents; however, return to previous sports activity and level is often not achieved. The principles of reconstructive surgical management include internal fixation of osteochondral fragments, bone marrow stimulation, autologous membrane-augmented chondrogenesis ± bone grafting, osteochondral transfer, retrograde techniques ± bone grafting, (matrix-associated) autologous chondrocyte implantation and autologous osteoperiosteal graft from the iliac crest. Additional surgical procedures for ankle stabilization and deformity correction should be considered if necessary. Osteochondrale Läsionen (OCL) des Talus sind definiert als Knorpelschäden mit subchondraler Beteiligung. Die traumatische Genese ist bedeutsam; insbesondere Distorsionen und Frakturen am Sprunggelenk können zu Läsionen der Knorpeloberfläche und der subchondralen Lamelle führen. In der Folge können instabile Läsionen und subchondrale Zysten erhebliche andauernde Schmerzen und funktionelle Einschränkungen auslösen. Eine primäre konservative Therapie ist v. a. bei Kindern und Jugendlichen zu erwägen; die Rückkehr zu sportlicher Aktivität ist aber oft nur eingeschränkt realisierbar. Rekonstruktive operative Therapieprinzipien umfassen interne Fixation des osteochondralen Fragments, Knochenmarkstimulation, membranaugmentierte Chondrogenese ± Spongiosaplastik, osteochondralen Transfer, retrograde Techniken ± Spongiosaplastik, (matrixassoziierte) autologe Chondrozytenimplantation und autologe Transplantation von osteoperiostalem Beckenkamm. Ergänzende operative Verfahren zur Stabilisierung bzw. Achskorrektur sind ggf. zu erwägen.
Autres résumés
Type: Publisher
(ger)
Osteochondrale Läsionen (OCL) des Talus sind definiert als Knorpelschäden mit subchondraler Beteiligung. Die traumatische Genese ist bedeutsam; insbesondere Distorsionen und Frakturen am Sprunggelenk können zu Läsionen der Knorpeloberfläche und der subchondralen Lamelle führen. In der Folge können instabile Läsionen und subchondrale Zysten erhebliche andauernde Schmerzen und funktionelle Einschränkungen auslösen. Eine primäre konservative Therapie ist v. a. bei Kindern und Jugendlichen zu erwägen; die Rückkehr zu sportlicher Aktivität ist aber oft nur eingeschränkt realisierbar. Rekonstruktive operative Therapieprinzipien umfassen interne Fixation des osteochondralen Fragments, Knochenmarkstimulation, membranaugmentierte Chondrogenese ± Spongiosaplastik, osteochondralen Transfer, retrograde Techniken ± Spongiosaplastik, (matrixassoziierte) autologe Chondrozytenimplantation und autologe Transplantation von osteoperiostalem Beckenkamm. Ergänzende operative Verfahren zur Stabilisierung bzw. Achskorrektur sind ggf. zu erwägen.
Identifiants
pubmed: 33666680
doi: 10.1007/s00113-021-00964-1
pii: 10.1007/s00113-021-00964-1
doi:
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
319-332Références
Weber CD, Klos K, Mückley T et al (2018) Rückfußverletzungen – Frakturen von Kalkaneus, Talus und peritalare Luxationen. Orthop Unfallchir Up2date 13:471–498
Kerkhoffs G, Karlsson J (2019) Osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 27:2719–2720
pubmed: 31401666
Flick AB, Gould N (1985) Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. Foot Ankle Int 5:165–185
Tol JL, Struijs PA, Bossuyt PM et al (2000) Treatment strategies in osteochondral defects of the talar dome: a systematic review. Foot Ankle Int 21:119–126
pubmed: 10694023
Van Dijk CN, Reilingh ML, Zengerink M et al (2010) Osteochondral defects in the ankle: why painful? Knee Surg Sports Traumatol Arthrosc 18:570–580
pubmed: 20151110
pmcid: 2855020
Martijn HA et al (2020) High incidence of (osteo)chondral lesions in ankle fractures. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06187-y
doi: 10.1007/s00167-020-06187-y
pubmed: 32761358
Irwin RM, Shimozono Y, Yasui Y et al (2018) Incidence of coexisting talar and tibial osteochondral lesions correlates with patient age and lesion location. Orthop J Sports Med 6:2325967118790965
pubmed: 30151402
pmcid: 6108024
Sorrento DL, Mlodzienski A (2000) Incidence of lateral talar dome lesions in SER IV ankle fractures. J Foot Ankle Surg 39:354–358
pubmed: 11131471
Stufkens SAS, Van den Bekerom MPJ, Kerkhoffs GMMJ et al (2011) Long-term outcome after 1822 operatively treated ankle fractures: a systematic review of the literature. Injury 42:119–127
pubmed: 20444447
Regier M, Petersen JP, Hamurcu A et al (2016) High incidence of osteochondral lesions after open reduction and internal fixation of displaced ankle fractures: medium-term follow-up of 100 cases. Injury 47:757–761
pubmed: 26657889
Looze CA, Capo J, Ryan MK et al (2017) Evaluation and management of osteochondral lesions of the talus. Cartilage 8:19–30
pubmed: 27994717
Körner D, Ateschrang A, Schröter S et al (2020) Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 28:3339–3346
pubmed: 32240347
Berndt AL, Harty M (1959) Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am 41-a:988–1020
pubmed: 13849029
Dahmen J, Lambers KTA, Reilingh ML et al (2018) No superior treatment for primary osteochondral defects of the talus. Knee Surg Sports Traumatol Arthrosc 26:2142–2157
pubmed: 28656457
Loomer R, Fisher C, Lloyd-Smith R et al (1993) Osteochondral lesions of the talus. Am J Sports Med 21:13–19
pubmed: 8427354
Casari FA et al (2020) The role of magnetic resonance imaging in autologous matrix-induced chondrogenesis for osteochondral lesions of the talus: analyzing MOCART 1 and 2.0. Cartilage: 1947603520946382. https://doi.org/10.1177/1947603520946382
doi: 10.1177/1947603520946382
pubmed: 32940049
Hepple S, Winson IG, Glew D (1999) Osteochondral lesions of the talus: a revised classification. Foot Ankle Int 20:789–793
pubmed: 10609707
Yasui Y, Hannon CP, Fraser EJ et al (2019) Lesion size measured on MRI does not accurately reflect arthroscopic measurement in talar osteochondral lesions. Orthop J Sports Med 7:2325967118825261
pubmed: 30800691
pmcid: 6378450
Jung HG, Kim NR, Jeon JY et al (2018) CT arthrography visualizes tissue growth of osteochondral defects of the talus after microfracture. Knee Surg Sports Traumatol Arthrosc 26:2123–2130
pubmed: 28624855
Nakasa T, Ikuta Y, Yoshikawa M et al (2018) Added value of preoperative computed tomography for determining cartilage degeneration in patients with osteochondral lesions of the talar dome. Am J Sports Med 46:208–216
pubmed: 29016192
Van Bergen CJ, Tuijthof GJ, Blankevoort L et al (2012) Computed tomography of the ankle in full plantar flexion: a reliable method for preoperative planning of arthroscopic access to osteochondral defects of the talus. Arthroscopy 28:985–992
pubmed: 22342200
Leumann A, Valderrabano V, Plaass C et al (2011) A novel imaging method for osteochondral lesions of the talus—comparison of SPECT-CT with MRI. Am J Sports Med 39:1095–1101
pubmed: 21300809
Ferkel RD, Zanotti RM, Komenda GA et al (2008) Arthroscopic treatment of chronic osteochondral lesions of the talus: long-term results. Am J Sports Med 36:1750–1762
pubmed: 18753679
Verhagen RA, Maas M, Dijkgraaf MG et al (2005) Prospective study on diagnostic strategies in osteochondral lesions of the talus. Is MRI superior to helical CT? J Bone Joint Surg Br 87:41–46
pubmed: 15686236
Oji DE, Mccall DA, Schon LC et al (2014) Diagnosis of osteochondral defects by arthroscopy. In: van Dijk CN, Kennedy JG (Hrsg) Talar osteochondral defects: diagnosis, planning, treatment, and rehabilitation. Springer, Berlin, Heidelberg, New York, S 43–50
O’loughlin PF, Heyworth BE, Kennedy JG (2010) Current concepts in the diagnosis and treatment of osteochondral lesions of the ankle. Am J Sports Med 38:392–404
pubmed: 19561175
Seo SG, Kim JS, Seo D‑K et al (2018) Osteochondral lesions of the talus. Acta Orthop 89:462–467
pubmed: 29635971
pmcid: 6600130
Weigelt L, Laux CJ, Urbanschitz L et al (2020) Long-term prognosis after successful nonoperative treatment of osteochondral lesions of the talus: an observational 14-year follow-up study. Orthop J Sports Med 8:2325967120924183
pubmed: 32537476
pmcid: 7268150
Reilingh ML, Murawski CD, Digiovanni CW et al (2018) Fixation techniques: proceedings of the international consensus meeting on cartilage repair of the ankle. Foot Ankle Int 39:23S–27S
pubmed: 30215310
Kerkhoffs G et al (2020) Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects: operative technique. Oper Orthop Traumatol. https://doi.org/10.1007/s00064-020-00673-9
doi: 10.1007/s00064-020-00673-9
pubmed: 32902691
Dombrowski ME, Yasui Y, Murawski CD et al (2018) Conservative management and biological treatment strategies: proceedings of the international consensus meeting on cartilage repair of the ankle. Foot Ankle Int 39:9s–15s
pubmed: 30215314
Kumai T, Takakura Y, Kitada C et al (2002) Fixation of osteochondral lesions of the talus using cortical bone pegs. J Bone Joint Surg Br 84:369–374
pubmed: 12002495
Haraguchi N, Shiratsuchi T, Ota K et al (2020) Fixation of the osteochondral talar fragment yields good results regardless of lesion size or chronicity. Knee Surg Sports Traumatol Arthrosc 28:291–297
pubmed: 31542817
Kerkhoffs GM, Reilingh ML, Gerards RM et al (2016) Lift, drill, fill and fix (LDFF): a new arthroscopic treatment for talar osteochondral defects. Knee Surg Sports Traumatol Arthrosc 24:1265–1271
pubmed: 24841940
Dahmen J, Altink JN, Reilingh ML et al (2019) Lift, drill, fill, and fix (LDFF): a new arthroscopic treatment for talar osteochondral defects. In: Canata GL, d’Hooghe P, Hunt KJ, Kerkhoffs GMMJ, Longo UG (Hrsg) Sports injuries of the foot and ankle: a focus on advanced surgical techniques. Springer, Berlin, Heidelberg, New York, S 141–147
Dahmen J, Lambers KTA, Reilingh ML et al (2019) Minimally invasive management of osteochondral defects to the talus. In: Doral MN, Karlsson J, Nyland J, Benedetto KP (Hrsg) Intraarticular fractures: minimally invasive surgery, arthroscopy. Springer, Cham, S 375–385
Reilingh ML, Lambers KTA, Dahmen J et al (2018) The subchondral bone healing after fixation of an osteochondral talar defect is superior in comparison with microfracture. Knee Surg Sports Traumatol Arthrosc 26:2177–2182
pubmed: 28752185
Lambers KTA, Dahmen J, Reilingh ML et al (2020) Arthroscopic lift, drill, fill and fix (LDFF) is an effective treatment option for primary talar osteochondral defects. Knee Surg Sports Traumatol Arthrosc 28:141–147
pubmed: 31520147
Nakasa T, Ikuta Y, Ota Y et al (2019) Clinical results of bioabsorbable pin fixation relative to the bone condition for osteochondral lesion of the talus. Foot Ankle Int 40:1388–1396
pubmed: 31423819
Stone JW (1996) Osteochondral lesions of the talar dome. J Am Acad Orthop Surg 4:63–73
pubmed: 10795042
Park CH, Song KS, Kim JR et al (2020) Retrospective evaluation of outcomes of bone peg fixation for osteochondral lesion of the talus. Bone Joint J 102-b:1349–1353
pubmed: 32993333
Toale J, Shimozono Y, Mulvin C et al (2019) Midterm outcomes of bone marrow stimulation for primary osteochondral lesions of the talus: a systematic review. Orthop J Sports Med 7:2325967119879127
pubmed: 31696137
pmcid: 6822192
Hurley ET, Shimozono Y, Mcgoldrick NP et al (2019) High reported rate of return to play following bone marrow stimulation for osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 27:2721–2730
pubmed: 29582098
Steman JAH, Dahmen J, Lambers KTA et al (2019) Return to sports after surgical treatment of osteochondral defects of the talus: a systematic review of 2347 cases. Orthop J Sports Med 7:2325967119876238
pubmed: 31673563
pmcid: 6806124
Valderrabano V, Miska M, Leumann A et al (2013) Reconstruction of osteochondral lesions of the talus with autologous spongiosa grafts and autologous matrix-induced chondrogenesis. Am J Sports Med 41:519–527
pubmed: 23393079
Ayyaswamy B et al (2020) Early to medium term outcomes of osteochondral lesions of the talus treated by autologous matrix induced chondrogenesis (AMIC). Foot Ankle Surg. https://doi.org/10.1016/j.fas.2020.04.008
doi: 10.1016/j.fas.2020.04.008
pubmed: 32414700
Becher C, Malahias MA, Ali MM et al (2019) Arthroscopic microfracture vs. arthroscopic autologous matrix-induced chondrogenesis for the treatment of articular cartilage defects of the talus. Knee Surg Sports Traumatol Arthrosc 27:2731–2736
pubmed: 30392029
Luick L, Steinmetz G, Haleem A (2020) All-arthroscopic osteochondral autograft transfer technique for osteochondritis dissecans of the talus. Arthrosc Tech 9:e499–e503
pubmed: 32368470
pmcid: 7189212
Hangody L, Kish G, Módis L et al (2001) Mosaicplasty for the treatment of osteochondritis dissecans of the talus: two to seven year results in 36 patients. Foot Ankle Int 22:552–558
pubmed: 11503979
Flynn S, Ross KA, Hannon CP et al (2016) Autologous osteochondral transplantation for osteochondral lesions of the talus. Foot Ankle Int 37:363–372
pubmed: 26666678
Gross AE, Agnidis Z, Hutchison CR (2001) Osteochondral defects of the talus treated with fresh osteochondral allograft transplantation. Foot Ankle Int 22:385–391
pubmed: 11428756
Jackson AT, Drayer NJ, Samona J et al (2019) Osteochondral allograft transplantation surgery for osteochondral lesions of the talus in athletes. J Foot Ankle Surg 58:623–627
pubmed: 31010770
Lenz CG et al (2020) Matrix-Induced Autologous Chondrocyte Implantation (MACI) Grafting for Osteochondral Lesions of the Talus. Foot Ankle Int: 1071100720935110
Niemeyer P, Salzmann G, Schmal H et al (2012) Autologous chondrocyte implantation for the treatment of chondral and osteochondral defects of the talus: a meta-analysis of available evidence. Knee Surg Sports Traumatol Arthrosc 20:1696–1703
pubmed: 22037894
Leumann A, Valderrabano V, Wiewiorski M et al (2014) Bony periosteum-covered iliac crest plug transplantation for severe osteochondral lesions of the talus: a modified mosaicplasty procedure. Knee Surg Sports Traumatol Arthrosc 22:1304–1310
pubmed: 23851923
Hu Y, Guo Q, Jiao C et al (2013) Treatment of large cystic medial osteochondral lesions of the talus with autologous osteoperiosteal cylinder grafts. Arthroscopy 29:1372–1379
pubmed: 23906276
Deng E, Shi W, Jiang Y et al (2020) Comparison of autologous osteoperiosteal cylinder and osteochondral graft transplantation in the treatment of large cystic osteochondral lesions of the talus (OLTs): a protocol for a non-inferiority randomised controlled trial. BMJ Open 10:e33850
pubmed: 32041859
pmcid: 7045089
Boffa A, Previtali D, Altamura SA et al (2020) Platelet-rich plasma augmentation to microfracture provides a limited benefit for the treatment of cartilage lesions: a meta-analysis. Orthop J Sports Med 8:2325967120910504
pubmed: 32341925
pmcid: 7175068