J Korean Foot Ankle Soc.  2020 Jun;24(2):42-47. 10.14193/jkfas.2020.24.2.42.

If the Lower Extremity Alignment is Corrected, Will Osteochondral Lesions of the Talus Improve?

• Kim YM
• Kim KI
• Han B

• KMID: 2502908
• DOI: http://doi.org/10.14193/jkfas.2020.24.2.42

Abstract

Increased loading in a localized area is a possible cause of pain-related osteochondral lesions of the talus (OLT), but the reported effects of realignment surgery for OLT have been anecdotal. Moreover, no report of realignment surgery for OLT could be found in the English literature. This study reviewed previous articles on lower extremity alignment and OLT to determine if OLT can be treated with realignment surgery.

Keyword

Osteochondral lesion of the talus; Lower extremity alignment; Realignment surgery

Figure

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  Figure. 1 Effects of medial and lateral displacement calcaneal osteotomies on tibiotalar joint contact stresses (by Steffensmeier et al.17)) (A) Prepare 8 fresh frozen cadaver. (B) Calcaneus was osteotomized and then displaced inferior fragment 1 cm medial and lateral side. (C) Divide talar dome for 4 zone (lateral to medial).

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  Figure. 2 The effect of calcaneal osteotomy on contact characteristics of the tibiotalar joint (Fairbank et al.18)). Manual dynamic load was applied to normal ankle model and artificially made flat foot model.

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  Figure. 3 One patient’s case who had valgus heel alignment and large cystic medial osteochondral lesion of the talus (OLT) with intractable lateral impingement symptom. (A) Preoperative plain radiographs show valgus heel alignment (left), flat arch (middle), and medial OLT (right) on her left foot and ankle. (B) Medial displacement calcaneal osteotomy was done for the relief of lateral impingement symptom. (B; left) Postoperative 9 months standing lateral foot and ankle plain radiograph. (B; right) Postoperative 9 months hindfoot alignment view. (C) Postoperative 17 months computed tomography (CT) scanning (bottom) shows decreased size of cystic medial OLT in comparison with preoperative CT scanning (top).

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  Figure. 4 (A) One patient had valgus heel alignment (left), varus ankle deformity (middle) and lateral osteochondral lesion of the talus (OLT) (right) on her right foot and ankle preoperatively. (B) Preoperative lateral OLT lesion was decreased after undergoing supramalleolar osteotomy and medial displacement calcaneal osteotomy. (B; left) Preoperative computed tomography (CT) scan coronal view. (B; right) Postoperative 4 year CT scan coronal view.

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