Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Subchondral bone is violated through the tibiotalar joint arthroscopically
57%
900/1572
Subchondral bone is accessed through the sinus tarsi as to not further violate the joint surface
14%
215/1572
Autologous cartilage is transferred from the knee
15%
231/1572
Autologous cartilage is transferred from the posterolateral talus
8%
130/1572
Hyaline cartilage will be present 6 months following the procedure
5%
81/1572
Select Answer to see Preferred Response
Chronic medial talar dome osteochondral defects <1cm in diameter are best treated with antegrade microfracture. Antegrade bone marrow stimulation (microfracture) is a commonly utilized first line treatment for talar osteochondral (OCD) lesions <1 cm in size. Violation of the subchondral bone using an awl perpendicular to the base of the lesion promotes healing and results in a fibrocartilaginous layer over the previously identifiable OCD. Lesions >1 cm and with an intact cartilage cap are best treated with retrograde drilling, while larger lesions may also be treated with more invasive procedures including autologous chondrocyte implantation (ACI) or bulk allografting. Savage-Elliott et al review the current concepts and evidence as it relates to osteochondral lesions of the talus. They report bone marrow stimulation procedures to be the best and most commonly utilized first line treatment for small talar OCD lesions. They conclude excellent results with lesions <1.5 cm2, with the best results in those patients with lesions <1cm. Ahmad et al compare outcomes following osteochondral autograft and allografts for the treatment of large talar OCD lesions. They report that fresh talar osteochondral allograft provided results comparable to the use of distal femoral osteochondral autograft for these lesions. They conclude that while allograft avoids the risk of harvesting from the knee, they believe it to lower healing potential. Flynn et al review autologous osteochondral transplantation (AOT) for lesions of the talus. They report a mean improvement of FAOS scores with no difference in outcomes in patients who underwent previous bone marrow stimulation procedure or other procedures. They conclude that AOT is an effective treatment for large talar OCDs measuring >1.5cm. Incorrect Answers: Answer 2: Retrograde drilling is best used for lesions >1cm2 and with an intact cartilage cap. Answer 3: Autologous cartilage transfer from the knee is used to treat larger cartilage defects of the talus. Answer 4: Autologous cartilage transfer from the posterior talus is not a described technique for treating OCD lesions of the talus. Answer 5: Fibrocartilage, not hyaline cartilage, is produced following bone marrow stimulation procedures.
2.3
(3)
Please Login to add comment