Tram Track Lesion of the Talar Dome

Kim, Seung Ho; Ha, Kwon Ick; Ahn, Jin Hwan; Koo, Ja Seong

Abstract

PURPOSE: We report a distinctive lesion in the articular cartilage of the talar dome in anterior bony impingement syndrome of the joint.
MATERIALS AND METHODS
Arthroscopic debridement was done in 68 ankles under the diagnosis of anterior impingement syndrome of the ankle joint between October 1994 and June 1996. There were 6 tram track lesions of talar dome of the 68 ankles. We evaluated arthroscopic findings of tramtrack lesion, injury mechanism, and treatment results according to the criteria of Ogilvie-Harris DJ et al.
RESULTS
All six male patients were professional or collegiate soccer players. Average age was 29 years (26 to 34). All 6 cases were dorminant ankles. Trauma history was not definite in all 6 cases. All 6 patients were anterior impingement syndrome of the ankle and treated by arthroscopic removal of osteophytes. The cartilage lesions were full thickness defects, located in the anterior half of the medial aspect of the talar dome and were longitudinal with variable widths resembling a tram track, thus named ""tram track lesion"". Tram track lesion and osteophytes were contacted by ankle dorsiflexion. Overall, good and excellent results were achieved in five patients at a mean follow up of twenty-seven months. Two cases had recurrences of osteophytes.
CONCLUSIONS
Tram track lesion of talar dome occurred by repeated scratching of the osteophyte of distal tibia and treated effectively by arthroscopic removal of osteophyte and debridement.