Chondral Osteochondral Defect Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. The blood supply to the talus is not as rich as many other bones in the body, and as a result injuries to the talus sometimes are more difficult to heal than similar injuries in other bones. The joint feels unstable and won’t straighten fully. For arthroscopic repair techniques a hyaluronic acid membrane was used to support cells and specifically designed instrumentation was developed. 2020 Oct 7;15(10):e0240134. This technique is suitable for younger to middle age patients with very focal areas of cartilage loss (typically less than 2 square centimeters) and where the remaining cartilage is healthy. OCD usually causes pain during and after sports. doi: 10.1177/0363546509349928. Some healthy flaps of cartilage can be repaired by special techniques.  This would need to be discussed in detail with your surgeon. Giannini S, Buda R, Vannini F, Di Caprio F, Grigolo B. Please enable it to take advantage of the complete set of features! 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. Average follow-up was 148 months (range, 85 to 198). Often what is required is the use of a fresh donor graft of bone and cartilage that is specifically matched to the size and dimensions of the defect. These will be used to determine the type and extent of the damaged area, and for measurement purposes to determine the possible treatment options. Giannini S, Battaglia M, Buda R, Cavallo M, Ruffilli A, Vannini F. Am J Sports Med. Dr Joachim Feger ◉ and Assoc Prof Frank Gaillard ◉ ◈ et al. Type 3: Slight disruption or depression of the normal contour of the cortical surface/subchondral lamella, often associated with type 2 lesion (small osteochondral fractures). The aims of this study are to describe evolution in cartilage repair from open field autologous chondrocyte implantation to regeneration by arthroscopic bone-marrow-derived cells (BMDCs) "one step" technique; to present the results of a series of patients consecutively treated and to compare in detail the different techniques used in order to establish the advantages obtained with the evolution in cartilage regenerative methods. Epub 2008 Jan 28. Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. Another classification for the 3 …  |  Epub 2010 Oct 8. It is widely accepted that chondral injuries in a weight-bearing portion of the knee may progress to osteoarthritis. [ 11] A Doctors, Clinics & Locations, Conditions & Treatments, View All Information for Patients & Visitors ». A chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones).  An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. Epub 2012 Dec 5. NLM Purpose:This study aimed to evaluate the clinical outcome and graft survival following coronoid reconstruction with osteochondral bone grafts for post-traumatic coronoid … Epub 2019 Nov 11. PLoS One. Eder C, Schmidt-Bleek K, Geissler S, Sass FA, Maleitzke T, Pumberger M, Perka C, Duda GN, Winkler T. Mol Biol Rep. 2020 Jun;47(6):4789-4814. doi: 10.1007/s11033-020-05428-0. Mesenchymal stromal cell and bone marrow concentrate therapies for musculoskeletal indications: a concise review of current literature.  You can message your clinic, view lab results, schedule an appointment, and pay your bill. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. The talar dome has no direct muscle attachments(2); during norm… However, the now exposed bone should be treated, if possible, to attempt to stimulate growth of new cartilage. CASE REPORT Traumatic Osteochondral Injury of the Femoral Head Treated by Mosaicplasty: A Report of Two Cases Denis Nam, MD& Michael K. Shindle, MD& Robert L. … One-step repair in talar osteochondral lesions: 4-year clinical results and t2-mapping capability in outcome prediction. The knee and the ankle joint are the most commonly involved joints for OCLs in the lower extremity. Clin Podiatr Med Surg. The talar dome is a trapezoid-shaped protuberance of the talus, 2.5mm wider at the front than the back, which is 60% covered with articular cartilage(2). J Bone Joint Surg Am. Patients of all the three groups underwent a second arthroscopy with a bioptic cartilage harvest at 1 year follow-up. Arthroscopic Drilling for the Treatment of Osteochondral Lesions of the Talus Nonoperatively managed stage 5 osteochondral talar lesions. eCollection 2020 Feb. Anal Bioanal Chem. COVID-19 is an emerging, rapidly evolving situation. Giannini S, Buda R, Battaglia M, Cavallo M, Ruffilli A, Ramponi L, Pagliazzi G, Vannini F. Am J Sports Med.  |  Acta Orthop Traumatol Turc. 2009 Apr;26(2):205-26. doi: 10.1016/j.cpm.2009.01.003. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. NIH An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Get the iPhone MyHealth app »  |  Specifically, tears of the MCL account for only six documented cases in the literature [3,6-8]. Giannini, S, Buda, R, Cavallo, M. Cartilage repair evolution in post-traumatic osteochondral lesions of the talus: from open field autologous chondrocyte to bone-marrow–derived cells transplantation. 2010 Nov;41(11):1196-203. doi: 10.1016/j.injury.2010.09.028. HHS Another technique, typically reserved for larger areas of loss and some forms of osteochondral defects, is to perform a transplant procedure. 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. They can also occur following severe trauma to the knee such as a skiing accident where the meniscus/cartilage is damaged. Osteochondral defects (OCD) or lesions (OCL) are focal areas of damage with articular cartilage damage and injury of the adjacent subchondral bone plate and subchondral cancellous bone. Numerous factors are considered when evaluating these disorders for the correct treatment and each scenario should be discussed in detail with your surgeon. 2019 Sep;53(5):372-375. doi: 10.1016/j.aott.2019.04.002. 2013 Mar;41(3):511-8. doi: 10.1177/0363546512467622. This would be the optimal scenario. Am J Sports Med. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Among the OLT, up to 94% of the lateral lesions are said to be secondary to trauma while only 62% of medial lesions are post-traumatic. Therefore certain protocols will need to be followed after surgery to protect this area as well as contour the newly forming cartilage. The talus is the bottom bone of the ankle joint. 2019 Dec;411(30):7943-7955. doi: 10.1007/s00216-019-02148-8. 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