J Korean Foot Ankle Soc.  2019 Jun;23(2):43-51. 10.14193/jkfas.2019.23.2.43.

Current Updates in Treatment of Osteochondral Lesions of the Talus

• Park YH
• Kim JY
• Kim HJ

• KMID: 2449671
• DOI: http://doi.org/10.14193/jkfas.2019.23.2.43

Abstract

Despite the increasing number of osteochondral lesions of the talus, there are a lack of definite evidence-based treatment protocols. Several types of treatments are available, each having their advantages and disadvantages. First-line therapy consists of well-conducted conservative treatment. Surgical treatment is the second choice. Treatments are chosen based on the size of the lesion, location, chronicity, and the condition of the neighboring cartilage. This article reviews the current updates in the treatment of osteochondral lesions of the talus to help clinicians use the available treatment strategies more efficiently.

Keyword

Talus; Cartilage; Joint; Chondrocyte; Therapeutics

MeSH Terms

Cartilage
Chondrocytes
Clinical Protocols
Joints
Talus*

Figure

• 

  Figure 1 Bone marrow stimulation to the osteochondral lesion of talus. (A) Identification of the lesion. (B) Debridement of frayed or fibrillated cartilage. (C) Microfracture on subchondral plate. (D) Release of marrow elements from exiting perforations.

• 

  Figure 2 Retrograde drilling for the treatment of subchondral cyst. (A) Computed tomography (CT) image of subchondral cyst. (B) Arthroscopic image of intact overlying cartilage. (C) Retrograde drilling under fluoroscopy. (D) CT image at 12-month follow-up.

• 

  Figure 3 Use of matrix in the autologous chondrocyte implantation. (A) Debridement of the lesion. (B) Application of CartiFill® (Sewon Cellontech, Seoul, Korea).

• 

  Figure 4 Autologous osteochondral transplacement to an osteochondral lesion of talus using the Osteochondral Autograft Transfer System® (Arthrex, Naples, FL, USA). (A) Identification of the lesion after medial malleolar osteotomy. (B) Debridement of damaged cartilage. (C) Harvest of autograft from the knee. (D) Insertion of autograft into the recipient hole in the talus.

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