Osteochondral lesions of the talus

Marie E. Easley, Daniel L Latt, James R. Santangelo, Marc Merian-Genast, Japies A. Nunley

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

When nonsurgical measures fail, OLTs can be managed effectively in most cases with arthroscopic debridement and drilling/microfracture. Preopera-tively, it is important to verify the OLT as the source of pain and to stage the lesion with CT. Small-joint instruments combined with proper setup and technique afford access to most lesions. When the articular surface is disrupted, favorable results are achieved by de-briding the lesion to a stable rim, followed by penetration of the subchondral plate to stimulate the formation of fibrocartilage to fill the defect. When the articular surface is intact, retrograde drilling, with or without bone grafting, is effective at restoring subchondral support and relieving pain. Despite proper technique, some patients with OLTs fail to improve. Larger-diameter lesions, those as-sociated with subchondral cysts, and those that have failed arthroscopic treatment are candidates for OAT or ACI. These techniques have the po-tential to restore hyaline cartilage in the OLT. Perpendicular access to the talar dome is needed, which often necessitates ligament release or an osteotomy. Graft harvest from the knee may lead to persistent knee symptoms. OLTs that have failed OAT or ACI or that involve the talar shoulder or a significant portion of the talus may be treated with structural allograft reconstruction as an alternative to ankle arthrodesis.

Original languageEnglish (US)
Pages (from-to)616-630
Number of pages15
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume18
Issue number10
StatePublished - Oct 2010

Fingerprint

Talus
Joints
Knee
Fibrocartilage
Hyaline Cartilage
Bone Cysts
Pain
Stress Fractures
Bone Transplantation
Arthrodesis
Debridement
Osteotomy
Ligaments
Ankle
Allografts
Transplants
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Easley, M. E., Latt, D. L., Santangelo, J. R., Merian-Genast, M., & Nunley, J. A. (2010). Osteochondral lesions of the talus. Journal of the American Academy of Orthopaedic Surgeons, 18(10), 616-630.

Osteochondral lesions of the talus. / Easley, Marie E.; Latt, Daniel L; Santangelo, James R.; Merian-Genast, Marc; Nunley, Japies A.

In: Journal of the American Academy of Orthopaedic Surgeons, Vol. 18, No. 10, 10.2010, p. 616-630.

Research output: Contribution to journalArticle

Easley, ME, Latt, DL, Santangelo, JR, Merian-Genast, M & Nunley, JA 2010, 'Osteochondral lesions of the talus', Journal of the American Academy of Orthopaedic Surgeons, vol. 18, no. 10, pp. 616-630.
Easley ME, Latt DL, Santangelo JR, Merian-Genast M, Nunley JA. Osteochondral lesions of the talus. Journal of the American Academy of Orthopaedic Surgeons. 2010 Oct;18(10):616-630.
Easley, Marie E. ; Latt, Daniel L ; Santangelo, James R. ; Merian-Genast, Marc ; Nunley, Japies A. / Osteochondral lesions of the talus. In: Journal of the American Academy of Orthopaedic Surgeons. 2010 ; Vol. 18, No. 10. pp. 616-630.
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