Skip to main content
SpringerLink
Log in

Approach to Osteochondral Lesions of the Medial Talus

  • Chapter
  • First Online:
Talar Osteochondral Defects

  • 1158 Accesses

Abstract

Osteochondral lesions (OCL) of the talus are a challenge to access due to coverage by the tibial plafond and malleoli. As a result, a variety of approaches have been proposed to gain visualization and/or surgical access to talar lesions. Posteromedial and anterolateral OCLs were classically thought to be the most common location of talar lesions [ 42 ].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Abramowitz Y, Wollstein R, Barzilay Y, et al. Outcome of resection of a symptomatic os trigonum. J Bone Joint Surg Am. 2003;85-A:1051–7.

    PubMed  Google Scholar 

  2. Alexander IJ, Watson JT. Step-cut osteotomy of the medial malleolus for exposure of the medial ankle joint space. Foot Ankle. 1991;11:242–3.

    Article  CAS  PubMed  Google Scholar 

  3. Assenmacher JA, Kelikian AS, Gottlob C, Kodros S. Arthroscopically assisted autologous osteochondral transplantation for osteochondral lesions of the talar dome: an MRI and clinical follow-up study. Foot Ankle Int. 2001;22:544–51.

    CAS  PubMed  Google Scholar 

  4. Baltzer AW, Arnold JP. Bone-cartilage transplantation from the ipsilateral knee for chondral lesions of the talus. Arthroscopy. 2005;21:159–66.

    Article  PubMed  Google Scholar 

  5. Beals TC, Junko JT, Amendola A, Nickisch F, Saltzman CL. Minimally invasive distraction technique for prone posterior ankle and subtalar arthroscopy. Foot Ankle Int. 2010;31:316–9.

    Article  PubMed  Google Scholar 

  6. Calder JD, Sexton SA, Pearce CJ. Return to training and playing after posterior ankle arthroscopy for posterior impingement in elite professional soccer. Am J Sports Med. 2010;38:120–4.

    Article  PubMed  Google Scholar 

  7. Choi WJ, Park KK, Kim BS, Lee JW. Osteochondral lesion of the talus: is there a critical defect size for poor outcome? Am J Sports Med. 2009;37:1974–80.

    Article  PubMed  Google Scholar 

  8. Chuckpaiwong B, Berkson EM, Theodore GH. Microfracture for osteochondral lesions of the ankle: outcome analysis and outcome predictors of 105 cases. Arthroscopy. 2008;24:106–12.

    Article  PubMed  Google Scholar 

  9. Cohen BE, Anderson RB. Chevron-type transmalleolar osteotomy: an approach to medial talar dome lesions. Tech Foot Ankle Surg. 2002;1:158–62.

    Article  Google Scholar 

  10. Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME, Raikin SM. Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int. 2007;28:154–61.

    Article  PubMed  Google Scholar 

  11. Ferkel RD, Fischer SP. Progress in ankle arthroscopy. Clin Orthop Relat Res. 1989;240:210–20.

    PubMed  Google Scholar 

  12. Ferkel RD, Heath DD, Guhl JF. Neurological complications of ankle arthroscopy. Arthroscopy. 1996;12:200–8.

    Article  CAS  PubMed  Google Scholar 

  13. Ferkel RD, Scranton Jr PE. Arthroscopy of the ankle and foot. J Bone Joint Surg Am. 1993;75:1233–42.

    CAS  PubMed  Google Scholar 

  14. Hangody L, Rathonyi GK, Duska Z, Vasarhelyi G, Fules P, Modis L. Autologous osteochondral mosaicplasty: surgical technique. J Bone Joint Surg Am. 2004;86:65–72.

    PubMed  Google Scholar 

  15. Hatic SO, Berlet GC. Particulated juvenile articular cartilage graft (DeNovo NT Graft) for treatment of osteochondral lesions of the talus. Foot Ankle Spec. 2010;3:361–4.

    Article  PubMed  Google Scholar 

  16. Horibe S, Kita K, Natsu-ume T, Hamada M, Mae T, Shino K. A novel technique of arthroscopic excision of a symptomatic os trigonum. Arthroscopy. 2008;24:121–4.

    Article  PubMed  Google Scholar 

  17. Jarde O, Trinquier-Lautard JL, Garate F, de Lestang M, Vives P. Osteochondral lesions of the talar dome: surgical treatment in a series of 30 cases. Rev Chir Orthop Reparatrice Appar Mot. 2000;86:608–15.

    CAS  PubMed  Google Scholar 

  18. Jerosch J, Fadel M. Endoscopic resection of a symptomatic os trigonum. Knee Surg Sports Traumatol Arthrosc. 2006;14:1188–93.

    Article  PubMed  Google Scholar 

  19. Kennedy JG, Murawski CD. The treatment of osteochondral lesions of the talus with autologous osteochondral transplantation and bone marrow aspirate concentrate: surgical technique. Cartilage. 2011;2:327–36.

    Article  Google Scholar 

  20. Kruse DL, Ng A, Paden M, Stone PA. Arthroscopic De Novo NT(®) juvenile allograft cartilage implantation in the talus: a case presentation. J Foot Ankle Surg. 2012;51:218–21.

    Article  PubMed  Google Scholar 

  21. Lamb J, Murawski CD, Deyer TW, Kennedy JG. Chevron-type medial malleolar osteotomy: a functional, radiographic and quantitative T2-mapping MRI analysis. Knee Surg Sports Traumatol Arthrosc. 2013;21:1283–8.

    Google Scholar 

  22. Marumoto JM, Ferkel RD. Arthroscopic excision of the os trigonum: a new technique with preliminary clinical results. Foot Ankle Int. 1997;18:777–84.

    Article  CAS  PubMed  Google Scholar 

  23. Mintz DN, Tashjian GS, Connell DA, Deland JT, O’Malley M, Potter HG. Osteochondral lesions of the talus: a new magnetic resonance grading system with arthroscopic correlation. Arthroscopy. 2003;19:353–9.

    Article  PubMed  Google Scholar 

  24. Muir D, Saltzman CL, Tochigi Y, Amendola N. Talar dome access for osteochondral lesions. Am J Sports Med. 2006;34:1457–63.

    Article  PubMed  Google Scholar 

  25. Navid DO, Myerson MS. Approach alternatives for treatment of osteochondral lesions of the talus. Foot Ankle Clin. 2002;7:635–49.

    Article  PubMed  Google Scholar 

  26. O’Driscoll SW. The healing and regeneration of articular cartilage. J Bone Joint Surg Am. 1998;80:1795–812.

    PubMed  Google Scholar 

  27. Ogut T, Ayhan E, Irgit K, Sarikaya AI. Endoscopic treatment of posterior ankle pain. Knee Surg Sports Traumatol Arthrosc. 2011;19:1355–61.

    Article  PubMed  Google Scholar 

  28. O’Loughlin PF, Heyworth BE, Kennedy JG. Current concepts in the diagnosis and treatment of osteochondral lesions of the ankle. Am J Sports Med. 2010;38:392–404.

    Article  PubMed  Google Scholar 

  29. Oznur A. Medial malleolar window approach for osteochondral lesions of the talus. Foot Ankle Int. 2001;22:841–2.

    CAS  PubMed  Google Scholar 

  30. Ray RB, Coughlin EJ. Osteochondritis dissecans of the talus. J Bone Joint Surg. 1947;29:697–710.

    CAS  PubMed  Google Scholar 

  31. Scholten PE, Sierevelt IN, van Dijk CN. Hindfoot endoscopy for posterior ankle impingement. J Bone Joint Surg Am. 2008;90:2665–72.

    Article  CAS  PubMed  Google Scholar 

  32. Smyth NA, Fansa AM, Murawski CD, Kennedy JG. Platelet-rich plasma as a biological adjunct to the surgical treatment of osteochondral lesions of the talus. Tech Foot Ankle Surg. 2012;11:18–25.

    Article  Google Scholar 

  33. Smyth NA, Murawski CD, Levine DS, Kennedy JG. Hindfoot arthroscopic surgery for posterior ankle impingement: a systematic surgical approach and case series. Am J Sports Med. 2013;41:1869–76.

    Google Scholar 

  34. Sprague NF, Guhl JF, Olson DW. Specific complications: elbow, wrist, hip, and ankle. Complications in arthroscopy. New York: Raven; 1989. p. 99–224.

    Google Scholar 

  35. van Bergen CJA, Tujithof GJM, Blankvoort L, Maas M, Kerkoffs GMMJ, van Dijk CN. 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. 2012;28:985–92.

    Article  PubMed  Google Scholar 

  36. van Bergen CJA, Tujithof GJM, Blankvoort L, Maas M, Sierevelt IN, van Dijk CN. Arthroscopic accessibility of the talus quantified by computed tomography simulation. Am J Sports Med. 2012;40:2318–24.

    Article  PubMed  Google Scholar 

  37. van Bergen CJA, Tuijthof GJM, Sierevelt IN, van Dijk CN. Direction of the oblique medial malleolar osteotomy for exposure of the talus. Arch Orthop Trauma Surg. 2010;131:893–901.

    Article  PubMed Central  PubMed  Google Scholar 

  38. van Dijk CN, de Leeuw PA, Scholten PE. Hindfoot endoscopy for posterior ankle impingement. Surgical technique. J Bone Joint Surg Am. 2009;91:287–98.

    PubMed  Google Scholar 

  39. van Dijk CN, van Bergen CJ. Advancements in ankle arthroscopy. J Am Acad Orthop Surg. 2008;16:635–46.

    PubMed  Google Scholar 

  40. van Dijk CN, Scholten PE, Krips R. A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy. 2000;16:871–6.

    Article  PubMed  Google Scholar 

  41. Verhagen RA, Maas M, Dijkgraaf MG, Tol JL, Krips R, van Dijk CN. Prospective study on diagnostic strategies in osteochondral lesions of the talus. Is MRI superior to helical CT? J Bone Joint Surg Br. 2005;87:41–6.

    CAS  PubMed  Google Scholar 

  42. Verhagen RA, Struijs PA, Bossuyt PM, van Dijk CN. Systematic review of treatment strategies for osteochondral defects of the talar dome. Foot Ankle Clin. 2003;8:233–42.

    Article  PubMed  Google Scholar 

  43. Wallen EA, Fallat LM. Crescentic transmalleolar osteotomy for optimal exposure of the medial talar dome. J Foot Surg. 1989;28:389–94.

    CAS  PubMed  Google Scholar 

  44. Willits K, Sonneveld H, Amendola A, Giffin JR, Griffin S, Fowler PJ. Outcome of posterior ankle arthroscopy for hindfoot impingement. Arthroscopy. 2008;24:196–202.

    Article  PubMed  Google Scholar 

  45. Yilmaz C, Eskandari MM. Arthroscopic excision of the talar Stieda’s process. Arthroscopy. 2006;22:225.

    Article  PubMed  Google Scholar 

  46. Young KW, Deland JT, Lee KT, Lee YK. Medial approaches to osteochondral lesion of the talus without medial malleolar osteotomy. Knee Surg Sports Traumatol Arthrosc. 2010;18:634–7.

    Article  PubMed  Google Scholar 

  47. Zengerink M, Struijs PA, Tol JL, van Dijk CN. Treatment of osteochondral lesions of the talus: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2010;18:238–46.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Zengerink M, van Dijk CN. Complications in ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2012;20:1420–31.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of Interest

The author has no current conflict of interests with the products presented.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA

    Keir A. Ross BS, Niall A. Smyth MD & John G. Kennedy MD, MCh, FRCS (Orth)

Authors
  1. Keir A. Ross BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niall A. Smyth MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John G. Kennedy MD, MCh, FRCS (Orth)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John G. Kennedy MD, MCh, FRCS (Orth) .

Editor information

Editors and Affiliations

  1. Orthopaedic Surgery, University of Amsterdam Academic Medical Centre, Amsterdam, The Netherlands

    C. Niek van Dijk

  2. Orthopaedic Surgery and Traumatology, Hospital for Special Surgery, New York, New York, USA

    John G. Kennedy

Rights and permissions

Reprints and permissions

Copyright information

© 2014 ESSKA

About this chapter

Cite this chapter

Ross, K.A., Smyth, N.A., Kennedy, J.G. (2014). Approach to Osteochondral Lesions of the Medial Talus. In: van Dijk, C., Kennedy, J. (eds) Talar Osteochondral Defects. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45097-6_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-45097-6_8

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45096-9

  • Online ISBN: 978-3-642-45097-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation