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Review
. 2023 Aug 6;8(3):24730114231192961.
doi: 10.1177/24730114231192961. eCollection 2023 Jul.

Republication of "Osteochondral Lesions of the Talus: Current Concepts in Diagnosis and Treatment"

John R Steele  1 , Travis J Dekker  1 , Andrew E Federer  1 , Jordan L Liles  1 , Samuel B Adams  1 , Mark E Easley  1
Affiliations
Review

Republication of "Osteochondral Lesions of the Talus: Current Concepts in Diagnosis and Treatment"

John R Steele et al. Foot Ankle Orthop. .

Abstract

Osteochondral lesions of the talus (OLTs) are a difficult pathologic entity to treat. They require a strong plan. Lesion size, location, chronicity, and characteristics such as displacement and the presence of subchondral cysts help dictate the appropriate treatment required to achieve a satisfactory result. In general, operative treatment is reserved for patients with displaced OLTs or for patients who have failed nonoperative treatment for 3 to 6 months. Operative treatments can be broken down into cartilage repair, replacement, and regenerative strategies. There are many promising treatment options, and research is needed to elucidate which are superior to minimize the morbidity from OLTs.

Keywords: ACI; AMIC; MACI; OATS; OLT; PJCAT; allograft; microfracture; osteochondral lesions of the talus; osteochondritis dessicans.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.

Figures

Figure 1.
Figure 1.
Microfracture technique. (A, B) Debridement of medial talar dome osteochondral lesion of the talus (OLT) to stable margins. (C) Microfracture performed. (D) Marrow elements seen exiting microfracture perforations.
Figure 2.
Figure 2.
Autologous chondrocyte implantation (ACI). (A) Osteochondral lesion of the talus (OLT) (osteotomy performed). (B) OLT being debrided and chondrocytes being placed. (C) Periosteal patch being sutured over ACI. (D) Fibrin glue overlying ACI.
Figure 3.
Figure 3.
Osteochondral allograft transplantation. (A) Excision of talar shoulder lesion (osteotomy performed). (B) Talus with shoulder lesion removed. (C) Donor allograft with prepared graft removed. (D) Securing graft with 2 screws.
Figure 4.
Figure 4.
Particulated juvenile cartilage allograft transplantation. (A) Unstable medial talar dome osteochondral lesion of the talus. (B) Lesion debrided to stable margins. (C) Particulated juvenile cartilage allograft pieces were placed into the lesion bed. (D) The cartilage pieces were covered with fibrin glue.
Figure 5.
Figure 5.
Algorithm for treatment of osteochondral lesions of the talus (OLTs). ACI, autologous chondrocyte implantation; AMIC, autologous matrix-induced chondrogenesis; MACI, matrix-induced autologous chondrocyte implantation; OAT, osteochondral allograft transplantation; PJCAT, particulated juvenile cartilage allograft transplantation.
See this image and copyright information in PMC

Corrected and republished from

References

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