Skip to main content
SpringerLink
Log in

Etiology, Classifications, Mechanism of Action

  • Chapter
  • First Online:
Ankle Joint Arthroscopy

Abstract

Osteochondral lesions of the ankle are a significant cause of pain and functional impairment. These lesions affect people of all activity levels and may lead to progressive degenerative cartilage injury. Trauma is the most commonly cited etiologic factor. While plain radiography remains an important component of initial assessment, there may be a failure to diagnose osteochondral lesions if additional diagnostic imaging tools are not used. If injury to the osteochondral unit is suspected, comprehensive evaluation should include advanced imaging such as MRI to ensure accurate diagnosis, particularly in cases of persistent symptoms related to previous ankle trauma. Early diagnosis and accurate staging of osteochondral lesions will help ensure that appropriate treatment is provided in order to optimize outcomes.

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 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
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. König F. Über freie Körper in den Gelenken. Dtsch Z Chir. 1888;27:90–109.

    Article  Google Scholar 

  2. Kappis M. Weitere Beiträge zur traumatisch-mechanischen Entstehung der “spontanen” Knorpelablösungen (sogen. Osteochondritis dissecans). Langenbeck's Arch Surg. 1922;171(1):13–29.

    Google Scholar 

  3. You JY, Lee GY, Lee JW, Lee E, Kang HS. An osteochondral lesion of the distal tibia and fibula in patients with an osteochondral lesion of the talus on MRI: prevalence, location, and concomitant ligament and tendon injuries. Am J Roentgenol. 2016;206(2):366–72. https://doi.org/10.2214/AJR.15.14861.

    Article  Google Scholar 

  4. Bosien WR, Staples OS, Russell SW. Residual disability following acute ankle sprains. J Bone Joint Surg Am. 1955;37-A(6):1237–43. http://www.ncbi.nlm.nih.gov/pubmed/13271470.

    Article  CAS  Google Scholar 

  5. Paul J, Barg A, Pagensteert G, Valderrabano V, Imhoff AB. Osteochondral injuries of talus. In: Sports injuries. Berlin: Springer; 2015. p. 1763–71. https://doi.org/10.1007/978-3-642-36569-0_143.

    Chapter  Google Scholar 

  6. Vuurberg G, van Dijk CN. Osteochondral defects of the ankle. In: Arthroscopy. Berlin: Springer; 2016. p. 985–96. https://doi.org/10.1007/978-3-662-49376-2_81.

    Chapter  Google Scholar 

  7. Komenda GA, Ferkel RD. Arthroscopic findings associated with the unstable ankle. Foot Ankle Int. 1999;20(11):708–13. http://www.ncbi.nlm.nih.gov/pubmed/10582846

    Article  CAS  Google Scholar 

  8. DIGiovanni BF, Fraga CJ, Cohen BE, Shereff MJ. Associated injuries found in chronic lateral ankle instability. Foot Ankle Int. 2000;21(10):809–15. http://www.ncbi.nlm.nih.gov/pubmed/11128010

    Article  CAS  Google Scholar 

  9. Leontaritis N, Hinojosa L, Panchbhavi VK. Arthroscopically detected intra-articular lesions associated with acute ankle fractures. J Bone Joint Surg Am. 2009;91(2):333–9. https://doi.org/10.2106/JBJS.H.00584.

    Article  PubMed  Google Scholar 

  10. Sorrento DL, Mlodzienski A. Incidence of lateral talar dome lesions in SER IV ankle fractures. J Foot Ankle Surg. 2000;39(6):354–8. https://doi.org/10.1016/S1067-2516(00)80070-8.

    Article  CAS  PubMed  Google Scholar 

  11. Bauer RS, Ochsner PE. Nosology of osteochondrosis dissecans of the trochlea of the talus. Z Orthop Ihre Grenzgeb. 1987;125(2):194–200. https://doi.org/10.1055/s-2008-1044914.

    Article  CAS  PubMed  Google Scholar 

  12. Rödén S, Tillegård P, Unander-Scharin L. Osteochondritis dissecans and similar lesions of the talus: report of fifty-five cases with special reference to etiology and treatment. Acta Orthop Scand. 1953;23(1):51–66. https://doi.org/10.3109/17453675308991199.

    Article  PubMed  Google Scholar 

  13. Canale ST, Belding RH. Osteochondral lesions of the talus. J Bone Joint Surg Am. 1980;62(1):97–102. http://www.ncbi.nlm.nih.gov/pubmed/7351423

    Article  CAS  Google Scholar 

  14. Flick AB, Gould N. Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. Foot Ankle. 1985;5(4):165–85. http://www.ncbi.nlm.nih.gov/pubmed/3830846

    Article  CAS  Google Scholar 

  15. Alexander AH, Lichtman DM. Surgical treatment of transchondral talar-dome fractures (osteochondritis dissecans). Long-term follow-up. J Bone Joint Surg Am. 1980;62(4):646–52. http://www.ncbi.nlm.nih.gov/pubmed/7380861

    Article  CAS  Google Scholar 

  16. Stone J. Osteochondral lesions of the talar dome. J Am Acad Orthop Surg. 1996;4(2):63–73. http://www.ncbi.nlm.nih.gov/pubmed/10795042.

    Article  CAS  Google Scholar 

  17. Zengerink M, Struijs PAA, Tol JL, van Dijk CN. Treatment of osteochondral lesions of the talus: a systematic review. Knee Surg Sport Traumatol Arthrosc. 2010;18(2):238–46. https://doi.org/10.1007/s00167-009-0942-6.

    Article  Google Scholar 

  18. Berndt AL, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am. 1959;41-A:988–1020. http://www.ncbi.nlm.nih.gov/pubmed/13849029.

    Article  CAS  Google Scholar 

  19. Loomer R, Fisher C, Lloyd-Smith R, Sisler J, Cooney T. Osteochondral lesions of the talus. Am J Sports Med. 1993;21(1):13–9. http://www.ncbi.nlm.nih.gov/pubmed/8427354.

    Article  CAS  Google Scholar 

  20. Ferkel R, Sgaglione N, Del Pizzo W. Arthroscopic treatment of osteochondral lesions of the talus: long-term results. Orthop Trans. 1990;14:172–3.

    Google Scholar 

  21. Gerards RM, Opdam KTM, van Bergen CJA, van Dijk CN. Diagnostic imaging modalities for osteochondral defects of the talus. Fuß Sprunggelenk. 2015;13(2):78–84. https://doi.org/10.1016/j.fuspru.2015.04.003.

    Article  Google Scholar 

  22. Hepple S, Winson IG, Glew D. Osteochondral lesions of the talus: a revised classification. Foot Ankle Int. 1999;20(12):789–93. http://www.ncbi.nlm.nih.gov/pubmed/10609707

    Article  CAS  Google Scholar 

  23. Dipaola JD, Nelson DW, Colville MR. Characterizing osteochondral lesions by magnetic resonance imaging. Arthroscopy. 1991;7(1):101–4. http://www.ncbi.nlm.nih.gov/pubmed/2009106

    Article  CAS  Google Scholar 

  24. 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(4):353–9. https://doi.org/10.1053/jars.2003.50041.

    Article  PubMed  Google Scholar 

  25. Anderson IF, Crichton KJ, Grattan-Smith T, Cooper RA, Brazier D. Osteochondral fractures of the dome of the talus. J Bone Joint Surg Am. 1989;71(8):1143–52. http://www.ncbi.nlm.nih.gov/pubmed/2777840

    Article  CAS  Google Scholar 

  26. Pritsch M, Horoshovski H, Farine I. Arthroscopic treatment of osteochondral lesions of the talus. J Bone Joint Surg Am. 1986;68(6):862–5. http://www.ncbi.nlm.nih.gov/pubmed/3733774

    Article  CAS  Google Scholar 

  27. Ferkel RD, Zanotti RM, Komenda GA, et al. Arthroscopic treatment of chronic osteochondral lesions of the talus: long-term results. Am J Sports Med. 2008;36(9):1750–62. https://doi.org/10.1177/0363546508316773.

    Article  PubMed  Google Scholar 

  28. 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(2):154–61. https://doi.org/10.3113/FAI.2007.0154.

    Article  PubMed  Google Scholar 

  29. Hembree WC, Wittstein JR, Vinson EN, et al. Magnetic resonance imaging features of osteochondral lesions of the talus. Foot Ankle Int. 2012;33(7):591–7. https://doi.org/10.3113/FAI.2012.0001.

    Article  PubMed  Google Scholar 

  30. Bruns J, Rosenbach B, Kahrs J. Etiopathogenetic aspects of medial osteochondrosis dissecans tali. Sportverletz Sportschaden. 1992;6(2):43–9. https://doi.org/10.1055/s-2007-993526.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. O.A.S.I. Bioresearch Foundation Gobbi NPO, Milan, Italy

    Alberto Gobbi

  2. New York Presbyterian Hospital/Queens, New York, NY, USA

    Graeme P. Whyte

Authors
  1. Alberto Gobbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Graeme P. Whyte
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alberto Gobbi .

Editor information

Editors and Affiliations

  1. University La Sapienza, Latina, Italy

    Francesco Allegra

  2. Santa Maria del Carmine Hospital, Rovereto, Trento, Italy

    Fabrizio Cortese

  3. Department of Orthopedic, Malatesta Novello Clinic, Forli, Italy

    Francesco Lijoi

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gobbi, A., Whyte, G.P. (2020). Etiology, Classifications, Mechanism of Action. In: Allegra, F., Cortese, F., Lijoi, F. (eds) Ankle Joint Arthroscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-29231-7_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-29231-7_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-29230-0

  • Online ISBN: 978-3-030-29231-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation