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Arthroscopic treatment of osteochondral lesions of the talus.

A retrospective study of the arthroscopic treatment of transchondral fractures of the talar dome in 18 patients was conducted. Followup ranged from 3 months to 3 years; 10 patients had an average followup of 2 years (Group A) and 8 of 6.5 months (Group B). The 10 male and 8 female patients ranged in age from 14 to 40 years. Thirteen lesions were posteromedial while five were anterolateral. Fourteen of the 18 patients reported an inversion type injury to the ankle from playing various sports on weekends. One patient had a bimalleolar fracture of the ankle sustained in a car accident 18 months prior to referral, while the last patient in the series had a bilateral fracture of the os calcis from a work-related falling incident. All patients underwent conservative care for at least 4 months prior to referral. Arthroscopic treatment consisted of partial synovectomy, debridement of osteochondral lesions with removal of loose fragments, curettage, abrasion, and, in one case, drilling. For analysis of postoperative management, patients were divided into two groups, 10 with the 2 year followup comprising Group A and the 8 with the 6.5 month followup in Group B. Group A was nonweightbearing for 6 weeks while Group B was ambulatory 2 weeks postoperatively. Group A was fully ambulatory when the 6 week nonweightbearing period expired. All patients had a full range of motion at the time of suture removal (1 week to 10 days). Both groups were evaluated objectively and subjectively. Excellent or good results were obtained in 88% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Stress fracture of the talus following resection of a talocalcaneal coalition: a case report.

We report the case of a 15-year-old male with bilateral talocalcaneal coalition. Following resection of the symptomatic coalition, the patient developed a painful ankle. MR imaging revealed a stress fracture of the talar body. In this report we discuss presentation and treatment of a symptomatic talocalcaneal coalition complicated by a later stress fracture as well as a review of the literature.

Adolescent↗

Pigmented villonodular synovitis of the talus in a child.

An unusual case of localized pigmented villonodular synovitis of the ankle joint in a 3-year-old boy is described. The child was brought to the hospital because of abrupt onset of pain and joint effusion. A soft tissue mass eroding the talar dome was seen in roentgenograms. Exact diagnosis was established by excisional biopsy. Curettage of the lesion resulted in healing without recurrence at 10-year follow-up examination.

Ankle Joint↗

Osteochondritis dissecans of the talus: long-term results of surgical treatment.

Twenty patients with osteochondritis dissecans of the ankle were reviewed for a clinical and radiographical follow-up 9 to 15 years after surgery including multiple drilling of the lesion combined with excision of loose fragments. The short-term results of surgery were satisfactory: 85 degrees of the patients were improved or cured. At follow-up, more than half of the patients had some degree of pain during activity, and swelling of the ankle, but only a few had locking or pain at rest. Only one of the 18 patients without osteoarthritis at the time of surgery had developed generalized osteoarthritis at the follow-up. Although the initial good results of surgery were demonstrated to deteriorate with time, the procedure can still be recommended in patients with longstanding symptoms.

Adolescent↗

Arthroscopic removal of an osteoid osteoma of the talus: a case report.

This article describes a patient with a 10-year history of persistent ankle pain. Differential diagnosis included osteoid osteoma and anterior ankle impingement. This patient subsequently underwent arthroscopic excision of a lesion on the talar neck following a complete radiographic work-up, which was nondiagnostic. The diagnosis of osteoid osteoma was finalized upon pathologic study of the arthroscopic shavings. The use of a motorized instrument for excision did not preclude pathologic evaluation of the specimen. Therefore, in an accessible location on the talar neck, arthroscopic excision of an osteoid osteoma can be performed.

Adult↗

Treatment of osteochondritis dissecans of the talus: use of the mosaicplasty technique--a preliminary report.

A one-stage autogenous osteochondral grafting technique for the treatment of talar dome osteochondritis dissecans is described. Eleven patients with osteochondritis dissecans lesions, 10 mm or greater in diameter, were operated on using the mosaicplasty autogenous osteochondral transplantation technique. Osteochondral cylindrical grafts from the ipsilateral knee were delivered into the talar defect using specially designed tube chisels. These procedures were done by arthrotomy. With follow-up of 12 to 28 months (mean, 16 months), the patients returned to full activities and the results, using the Hannover scoring system, have been excellent.

Adolescent↗