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Papers of the Week


2021 Mar 05


Unfallchirurg

[Osteochondral lesions of the talus : Individualized approach based on established and innovative reconstruction techniques].

Authors

Weber C D, Kerkhoffs G, Dahmen J, Arbab D U, Kobbe P, Hildebrand F, Lichte P
Unfallchirurg. 2021 Mar 05.
PMID: 33666680.

Abstract

Osteochondral lesions (OCL) of the talus are defined as chondral damage with subchondral involvement. The traumatic etiology is important; in particular, sprains and fractures can lead to lesions of the articular surface and the subchondral plate. As a result, unstable lesions and subchondral cysts can trigger substantial persistent pain and functional impairments. A primary conservative treatment can be considered and is especially recommended in children and adolescents; however, return to previous sports activity and level is often not achieved. The principles of reconstructive surgical management include internal fixation of osteochondral fragments, bone marrow stimulation, autologous membrane-augmented chondrogenesis ± bone grafting, osteochondral transfer, retrograde techniques ± bone grafting, (matrix-associated) autologous chondrocyte implantation and autologous osteoperiosteal graft from the iliac crest. Additional surgical procedures for ankle stabilization and deformity correction should be considered if necessary.