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Review
. 2023 May 15;10(5):884.
doi: 10.3390/children10050884.

Juvenile Osteochondral Lesions of the Talus: Current Concepts Review and an Update on the Literature

Albert T Anastasio  1 , Kian Bagheri  1   2 , Emily M Peairs  1 , Caitlin Grant  1 , Samuel B Adams  1
Affiliations
Review

Juvenile Osteochondral Lesions of the Talus: Current Concepts Review and an Update on the Literature

Albert T Anastasio et al. Children (Basel). .

Abstract

Osteochondral lesions of the talus (OLTs) are lesions that occur before the physis closes and are frequently associated with acute ankle trauma. These lesions are often difficult to diagnose due to swelling and inflammation that are present after the initial injury. A growing body of literature has assessed the effects of OLTs in the adult population. However, the literature examining these lesions in the juvenile population is sparse. The purpose of this review is to provide a thorough understanding of OLTs, with a specific focus on the juvenile population. We evaluate the recent literature regarding the outcomes of various surgical treatment; modalities in the pediatric patient. While the outcomes after surgical treatment of pediatric OLTs are generally favorable, the paucity of investigation in this demographic is alarming. Further research is needed to better inform practitioners and families regarding these outcomes, as treatment plans are highly dependent on the individual patient in question.

Keywords: ankle; juvenile; microtrauma; osteoarthritis; osteochondral lesion of the talus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Preoperative radiographic imaging of a 14-year-old female (with distal tibial physis nearing complete closure) with evidence of OLT at the medial talar dome. (A) Lateral radiograph of the left foot demonstrates a lucent lesion with minimal sclerosis, most consistent with OLT. (B) Mortise view of the left ankle reveals the subtle OLT at the medial talar dome.
Figure 2
Figure 2
(A) Preoperative MRI in a 14-year-old female reveals further characteristics of the OLT. (A) Coronal MRI view reveals subchondral bone marrow edema. (B) Sagittal MRI view further defines the OLT, with associated bone marrow edema and joint effusion. After obtaining the MRI, given ongoing symptomology in the setting of OLT with associated lateral ligamentous instability, the decision was made to proceed with ankle arthroscopy, application of particulated juvenile allograft cartilage implant (DeNovo Graft, Zimmer Biomet; Warsaw, Indiana), and lateral ligamentous stabilization through a modified Bostrom procedure.
Figure 3
Figure 3
(A) Postoperative radiographic imaging of an 14-year-old female (A) Anteroposterior imaging reveals ongoing remodeling of OLT in the left medial talar dome. (B) Lateral radiograph reveals subtle improvement in subchondral cystic change indicative of remodeling.
See this image and copyright information in PMC

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References

    1. Dahmen J., Steman J.A.H., Buck T.M.F., Struijs P.A.A., Stufkens S.A.S., van Bergen C.J.A., Kerkhoffs G. Treatment of Osteochondral Lesions of the Talus in the Skeletally Immature Population: A Systematic Review. J. Pediatr. Orthop. 2022;42:e852–e860. doi: 10.1097/BPO.0000000000002175. - DOI - PMC - PubMed
    1. Cerrato R. Particulated juvenile articular cartilage allograft transplantation for osteochondral lesions of the talus. Foot Ankle Clin. 2013;18:79–87. doi: 10.1016/j.fcl.2012.12.005. - DOI - PubMed
    1. Vannini F., Cavallo M., Baldassarri M., Castagnini F., Olivieri A., Ferranti E., Buda R., Giannini S. Treatment of juvenile osteochondritis dissecans of the talus: Current concepts review. Joints. 2014;2:188–191. doi: 10.11138/jts/2014.2.4.188. - DOI - PMC - PubMed
    1. Wang C.C., Yang K.C., Chen I.H. Current treatment concepts for osteochondral lesions of the talus. Tzu Chi Med. J. 2021;33:243–249. doi: 10.4103/tcmj.tcmj_106_20. - DOI - PMC - PubMed
    1. Powers R.T., Dowd T.C., Giza E. Surgical Treatment for Osteochondral Lesions of the Talus. Arthroscopy. 2021;37:3393–3396. doi: 10.1016/j.arthro.2021.10.002. - DOI - PubMed

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