Skip to main content

One-Stage Treatment for Osteochondral Lesion of the Talus

  • Chapter
  • First Online:
Sports Injuries of the Foot and Ankle

Abstract

Chondral lesions of the talus are usually caused by acute ankle sprain or a chronic ankle instability due to insufficiency of the passive lateral ankle stabilizers. In most of the patients, the lesion remains asymptomatic for a long period of time. Pain, the first clinical symptom of the lesions, usually starts when subchondral bone is affected by the repetitive microtrauma and the chondral lesion becomes an on osteochondral lesion. That is why the patient who qualifies to be treated operatively usually has an osteochondral lesion that needs a bilayer reconstruction. In those cases a technique that is a combination of both bone and cartilage reconstruction is recommended. The biological osteochondral reconstruction (BIOR) technique allows the surgeon to not only treat the cartilage but also the underlying bone. In severe cases of osteochondral lesion, a sophisticated reconstruction of the talar dome shape is needed in order to regain the ankle joint congruency.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
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. Robinson DE, Winson IG, Harries WJ, Kelly AJ. Arthroscopic treatment of osteochondral lesions of the talus. J Bone Joint Surg (Br). 2003;85-B(7):989.

    Article  Google Scholar 

  2. Hangody L, Füles P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints. J Bone Joint Surg Am. 2003;85-A(Suppl 2):25.

    Article  Google Scholar 

  3. Valderrabano V, Leumann A, Rasch H, Egelhof T, Hintermann B, Pagenstert G. Knee-to-ankle mosaicplasty for the treatment of osteochondral lesions of the ankle joint. Am J Sports Med. 2009;37(1 suppl):105S–11S.

    Article  Google Scholar 

  4. Kodama N, Honjo M, Maki J, Hukuda S. Osteochondritis dissecans of the talus treated with the mosaicplasty technique: a case report. J Foot Ankle Surg. 2004;43(3):195–8.

    Article  Google Scholar 

  5. Gobbi A, Francisco RA, Lubowitz JH, Allegra F, Canata G. Osteochondral lesions of the talus: randomized controlled trial comparing chondroplasty, microfracture, and osteochondral autograft transplantation. Arthroscopy. 2006;22(10):1085–92.

    Article  Google Scholar 

  6. Emre TY, Ege T, Çift HT, Demircioğlu DT, Seyhan B, Uzun M. Open mosaicplasty in osteochondral lesions of the talus: a prospective study. J Foot Ankle Surg. 2012;51(5):556–60.

    Article  Google Scholar 

  7. Nakagawa Y, Suzuki T, Matsusue Y, Kuroki H, Mizuno Y, Nakamura T. Bony lesion recurrence after mosaicplasty for osteochondritis dissecans of the talus. Arthroscopy. 2005;21(5):630-e1.

    Article  Google Scholar 

  8. Gobbi A, Chaurasia S, Karnatzikos G, Nakamura N. Matrix-induced autologous chondrocyte implantation versus multipotent stem cells for the treatment of large patellofemoral chondral lesions a nonrandomized prospective trial. Cartilage. 2015;6(2):82–91.

    Article  CAS  Google Scholar 

  9. Gobbi A, Karnatzikos G, Sankineani SR. One-step surgery with multipotent stem cells for the treatment of large full-thickness chondral defects of the knee. Am J Sports Med. 2014;42(3):648–57.

    Article  Google Scholar 

  10. Valderrabano V, Miska M, Leumann A, Wiewiorski M. Reconstruction of osteochondral lesions of the talus with autologous spongiosa grafts and autologous matrix-induced chondrogenesis. Am J Sports Med. 2013;41(3):519–27.

    Article  Google Scholar 

  11. Buda R, Vannini F, Castagnini F, Cavallo M, Ruffilli A, Ramponi L, et al. Regenerative treatment in osteochondral lesions of the talus: autologous chondrocyte implantation versus one-step bone marrow derived cells transplantation. Int Orthop. 2015;39(5):893–900.

    Article  Google Scholar 

  12. Sadlik B, Kolodziej L, Blasiak A, Szymczak M, Warchal B. Biological reconstruction of large osteochondral lesions of the talar dome with a modified “sandwich” technique—midterm results. Foot Ankle Surg. 2016;23(4):290–5.

    Article  Google Scholar 

  13. Whyte GP, Gobbi A, Sadlik B. Dry arthroscopic single-stage cartilage repair of the knee using a hyaluronic acid-based scaffold with activated bone marrow-derived mesenchymal stem cells. Arthrosc Tech. 2016;5(4):e913–8.

    Article  Google Scholar 

  14. Sadlik B, et al. Surgical repair of osteochondral lesions of the talus using biologic inlay osteochondral reconstruction: clinical outcomes after treatment using a medial malleolar osteotomy approach compared to an arthroscopically-assisted approach. Foot Ankle Surg. 2018. https://doi.org/10.1016/j.fas.2018.02.010.

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 ISAKOS

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sadlik, B., Gobbi, A., Pałka, K., Herman, K. (2019). One-Stage Treatment for Osteochondral Lesion of the Talus. In: Canata, G., d'Hooghe, P., Hunt, K., Kerkhoffs, G., Longo, U. (eds) Sports Injuries of the Foot and Ankle. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58704-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-58704-1_14

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58703-4

  • Online ISBN: 978-3-662-58704-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics