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. 2014 Aug 1;2(3):115-23.
doi: 10.11138/jts/2014.2.3.115. eCollection 2014 Jul-Sep.

Osteochondritis dissecans of the talus

Giacomo Zanon  1 , Giovanni DI Vico  2 , Matteo Marullo  1
Affiliations

Osteochondritis dissecans of the talus

Giacomo Zanon et al. Joints. .

Abstract

Osteochondritis dissecans (OCD) is an acquired idiopathic lesion of subchondral bone that can produce delamination and sequestration with or without articular cartilage involvement and instability. The cause of OCD is still debated: the most recognized etiology is the occurrence of repetitive micro-traumas associated with vascular impairment, causing progressive ankle pain and dysfunction in skeletally immature and young adult patients. Ankle OCD is classically located in the medial part of the talus, while lateral and posterior involvement is less frequent. Diagnosis of OCD, based on MRI findings, is quite straightforward; MRI examination can also be very useful for dating the defect and obtaining information about the associated bone bruise. Osteochondritis dissecans, if not recognized and treated appropriately, may lead to secondary osteoarthritis with pain and functional limitation. Surgical treatment is mandatory especially in young patients with unstable cartilage fragments. There are various surgical options: fixation, microfracture, or substitution using autologous chondrocyte implantation techniques.

Keywords: ankle; autologous chondrocyte implantation; microfracture; osteochondritis dissecans; talus.

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Figures

Fig. 1
Fig. 1
Magnetic resonance images of the right ankle of a 19-year-old man with symptomatic OCD. A: Coronal proton density-weighted image that shows the OCD lesion detached from the supero-lateral corner of the talar dome, with loss of cartilage continuity. The lesion is classified as stage III. B: Sagittal T1-weighted image showing extensive subchondral bone edema.
Fig. 2
Fig. 2
Arthro-CT images of the right ankle of a 17-year-old girl. The patient is sedentary and asymptomatic. A: Coronal image showing a stage II lesion of the superomedial corner of the talar dome. The contrast medium does not breach the cavity, a sign of integrity of the cartilaginous layer. B: Sagittal image showing the extent of the lesion (1.7 cm wide).
Fig. 3
Fig. 3
Arthroscopic image of the right ankle of a 24-year-old footballer affected by stage IV OCD. After removal of the loose body, which was too fragmented to be refixed, microfractures were performed.
Fig. 4
Fig. 4
Postoperative X-ray of a 26-year-old man affected by stage IV OCD located in the postero-medial corner of the left talar dome. The patient underwent autologous matrix-induced chondrogenesis (AMIC). To reach the site of the lesion, a medial malleolus osteotomy was performed and then fixed with a lag screw.
See this image and copyright information in PMC

References

    1. Konig A. Uber freie Körper in den Gelenken. Dtsch Z Chir. 1888;27:90–103.
    1. Kappis M. Weitese Beitrage zur Traumatisch-mechanischen-Entstehung der “Spontanen” Knospelablosungen. Dtsch Z Chir. 1922;171:13–29.
    1. Aichroth P. Osteochondritis dissecans of the knee. A clinical survey. J Bone Joint Surg Br. 1971;53:440–447. - PubMed
    1. Steinhagen J, Niggemeyer O, Bruns J. Etiology and pathogenesis of osteochondrosis dissecans tali. Orthopade. 2001;30:20–27. - PubMed
    1. Bauer M, Jonsson K, Lindén B. Osteochondritis dissecans of the ankle. A 20-year follow-up study. J Bone Joint Surg Br. 1987;69:93–96. - PubMed