Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. CrossRef Google Scholar One patient required additional surgery for the osteochondral defect. (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. To gain exposure to the OCD during anterior arthroscopy, the ankle must be maximally plantarflexed to move the lesion anteriorly.424,432 However, some defects located in the posterior part of the talus may not be accessible by anterior arthroscopy.296,408 Especially if the OCD is located posteriorly and There may be slight spreading of either half of the epiphysis away from the cleft. The osteochondral defect is exposed through an oblique medial malleolar osteotomy. A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. 5. HHS Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. The posterior tibial tendon runs obliquely over the middle of the medial fragment (groove). When left untreated, however, osteochondral Objectives. Literature data do not report clinical records with significant number of cases and follow-up. 2017 Oct;34(4):471-487. doi: 10.1016/j.cpm.2017.05.005. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC. Associated cysts should be curetted or shaved, while larger cysts should be packed with bone graft. On MR imaging, osteochondral defect of the tibial plafond has low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, with adjacent bone marrow edema (Figs.  |  Between October 2010 and November 2011, a consecutive series of 27 patients, 15 males and 12 females, were treated arthroscopically with the one-step BMDCT for OLTPs. NIH The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. 2014 Oct 15;96(20):1708-15. doi: 10.2106/JBJS.M.01370. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. We report the case of a 17-year-old male patient with large osteochondral defects in the distal tibia plafond after septic arthritis, in whom iliac … Clipboard, Search History, and several other advanced features are temporarily unavailable. Abstract: Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. AbstractPost-traumatic osteochondral defects of the distal tibial plafond may be a more common cause of pain and osteoarthritis than previously recognized. This osteotomy was measured Conclusions: A topographic study was also performed. Of these, only one was a … Ross KA, Hannon CP, Deyer TW, Smyth NA, Hogan M, Do HT, Kennedy JG. Epub 2017 Jul 29. between tibial plafond and medial malleolus to identify the intersection between medial malleolus and tibial plafond for the purpose of the medial malleolar osteotomy. Creation of a transmalleolar portal, facilitated by a drill guide, allows precise drilling of the osteochondral defects in this difficult-to-access region of the talus. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [, Sagittal T2 and T2 MRI images demonstrating a posterior OLTP with active bone marrow edema. Please enable it to take advantage of the complete set of features! Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. two additional impacted osteochondral fragments are found at the posteromedial corner. This would be the optimal scenario. Large Osteochondral Defects of the Distal Tibia Plafond After Septic Arthritis of the Ankle Joint Treated by Arthrodiastasis and Iliac Bone Graft: A Case Report Author links open overlay panel Toshifumi Hikichi MD 1 Hidenori Matsubara HM, MD, PhD 2 Shuhei Ugaji SU, MD, PhD 1 Tomo Hamada TH, MD, PhD 1 Hiroyuki Tsuchiya HT, MD, PhD 3 This study shows that the metal implantation technique is a promising treatment for osteochondral defects of the medial talar dome after failed previous treatment. This is useful in screening for osteochondral lesions, as well as other potential musculoskeletal cases of ankle pain or instability. COVID-19 is an emerging, rapidly evolving situation. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. The MRI is not however very accurate in determining the true size and depth of the lesion, nor the presence of subtle associated subchondral cysts, which are all better evaluated on CT scans (Fig. 2018. The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. (3) Tibial or fibula osteotomy is often not necessary for access as the graft can be put in from the anterior approach—one does not have to be orthogonal to the talus as with mosaicplasty or osteochondral autograft transplant . 3A and 3B). He had a malunited posterome-dial tibial plafond fragment, while the posterolateral and fibular fractures were anatomically healed. CONCLUSION: Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. [Arthroscopic treatment of chondral lesions of the ankle joint. A K-wire can be inserted into the talus through one of the predrilled holes to hold the eCollection 2019 Aug. Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond. The purpose of this study was to evaluate the clinical outcomes and the level of sports activity following arthroscopic microfracture for osteochondral lesions of the tibial plafond. 2009;6:524–9. Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. The majority of osteochondral lesions (OCLs) of the an-kle occur in the talus.1,2 Approximately 2.6% of isolat-ed OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature.3–5 There is no clear explanation why talar OCLs are more common than distal tibial … (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. OCD usually causes pain during and after sports. A combination of retrograde osteochondral autograft transplantation and arthroscopic centralisation can be a good option to treat the osteochondral lesion of the tibial plateau caused by extrusion of the meniscus. Osteochondral Defects . Its radiologic findings are similar to those of osteo- chondritis dissecans located elsewhere in … Tibial Plafond Osteochondral Lesion.OrthopaedicsOne Cases.In: OrthopaedicsOne - The Orthopaedic Knowledge Network.Created Feb 10, 2011 07:46. However, the literature on the surgical treatment of osteochondral defects of the distal tibial plafond is significantly limited. Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. This must be prevented in young athletes. Osteochondral defects (OCDs), also known as osteochondritis dissecans, can cause pain and decreased function in patients and offer a significant challenge to the foot and ankle surgeons. dome. Further studies with a longer follow-up and more accurate imaging studies are necessary to confirm these results. 1, 2 Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. Evidence-based therapy]. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. The second most common localization of the osteochondral defect in the OCD with loose bodies group was the medial plafond of distal tibia [in 9 of 29 (31.1%) patients]. Osteochondral Defects . Findings relating to the notch of Harty and ankle joint were recorded and analyzed, including qualitative assessment of the presence of the notch, focal chondral thinning or focal subcortical osteosclerosis at the notch, notch width and depth, osteochondral lesions elsewhere in the ankle, subchondral edema signal or cystic change at the tibial plafond, and the presence of an ankle joint effusion. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Literature data do not report clinical records with significant number of cases and follow-up. (1,2) Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. After creating the osteochondral defect, drilling was performed. —46-year-old man with ankle pain and swelling. Utilizing standard anteromedial and anterolateral portals, a diagnostic evaluation should be performed as described by Ferkel to evaluate for associated pathologies [, Arthroscopic view of OLTP in the central plafond, OLTP post debridement of unstable cartilage. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic treatment of distal tibia osteochondral lesions and to report our results with treating these rare lesions. Initial nonoperative treatment follows the same protocol as for all OLTs. Bone defects after septic arthritis of the ankle joint result in arthrodesis and severe loss of ankle motion. ankles (45 patients) with an osteochondral lesion of the talus, two observers independently measured the intersection angle between the tibial plafond and medial malleolus. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. It appeared that the use of ta lar osteochondral graft does not adversely affect the joint surface and easily incorporates into the surrounding surface cartilage. Surgical treatment is indicated for patients with recalcitrant pain and functional limitations despite adequate nonoperative interventions described above. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). For functional evaluation, the visual analog scale (VAS) pain score, Foot and Ankle Ability Measure (FAAM) score, and Short Form-12 (SF-12) general health questionnaire were used. Ankle; BMDCT; Cartilage; OLTP; Osteochondral lesions. It contains free information. An osteochondral defect that is in the early stages may be suitable for a repair technique to keep the native bone and cartilage. 2016 Feb;119(2):100-8. doi: 10.1007/s00113-015-0136-2. Osteochondral lesions of the tibial plafond (OLTP) are rare disorder compared with osteochondral lesions of the talus (OLT), and its frequency is 2.6% of osteochondral lesions of the ankle. Most OLTP can be surgically managed arthroscopically. Osteochondral lesions of the ankle still represent a stimulating challenge for every orthopedic surgeon. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6 . Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [ 2, 6 ]. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Tibial OCL . osteochondral defect. 2018 Jul;26(7):2116-2122. doi: 10.1007/s00167-017-4591-x. OBJECTIVES: Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. plafond. ed by the tibial plafond. In the knee, osteochondral defects were created at the medial femoral condyle (MFC) and patellar groove (PG). Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The tibial articular cartilage on the tibial plafond had also healed without articular surface defects. 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