Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. Radiographically, they are lucent defect traversing the length of epiphysis, and may have sharp or irregular borders. The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. instability was seen. (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. Unfallchirurg. Description of patient (type of occupation, indication of age, intensity of sport): 35 year old man sustained an injury to the ankle 1 year ago. In the knee, osteochondral defects were created at the medial femoral condyle (MFC) and patellar groove (PG). After creating the osteochondral defect, drilling was performed. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. This includes initial rest, immobilization, and unloading protocol, in either a fracture boot or cast. plafond. Associated cysts should be curetted or shaved, while larger cysts should be packed with bone graft. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. Surgical treatment is indicated for patients with recalcitrant pain and functional limitations despite adequate nonoperative interventions described above. The majority of osteochondral lesions (OCLs) of the an-kle occur in the talus.1,2 Approximately 2.6% of isolat-ed OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature.3–5 There is no clear explanation why talar OCLs are more common than distal tibial … The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 lesions (16%). A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. The majority of osteochondral lesions (OCLs) of the an-kle occur in the talus.1,2 Approximately 2.6% of isolat-ed OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature.3–5 There is no clear explanation why talar OCLs are more common than distal tibial … (3) Tibial or fibula osteotomy is often not necessary for access as the graft can be put in from the anterior approach—one does not have to be orthogonal to the talus as with mosaicplasty or osteochondral autograft transplant . At the ankle, defects were created in the talus at either a covered or uncovered area by the tibial plafond. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. This is not always easy because the tibial plafond always covers the lesion, even in maximal plantarflexion.  |  Fig. This study shows that the metal implantation technique is a promising treatment for osteochondral defects of the medial talar dome after failed previous treatment. Most OLTP can be surgically managed arthroscopically. Epub 2017 Jul 29. Results: ankles (45 patients) with an osteochondral lesion of the talus, two observers independently measured the intersection angle between the tibial plafond and medial malleolus. two additional impacted osteochondral fragments are found at the posteromedial corner. septic ankle. Of these, only one was a … Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. 2016 Feb;119(2):100-8. doi: 10.1007/s00113-015-0136-2. (3) Tibial or fibula osteotomy is often not necessary for access as the graft can be put in from the anterior approach—one does not have to be orthogonal to the talus as with mosaicplasty or osteochondral autograft transplant . The advent of CT and MR scanning has shown that they are commoner and more complex than was thought. It appeared that the use of ta lar osteochondral graft does not adversely affect the joint surface and easily incorporates into the surrounding surface cartilage. MRI scan - osteochondral lesion on the talus with "kissing" lesion on the plafond Although the majority of osteochondral lesions occur after a definite injury, some have no clear history of injury. Clipboard, Search History, and several other advanced features are temporarily unavailable. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). It has been suggested that these may be caused by local osteonecrosis or metabolic defects, but currently it is thought likely that most if not all are caused by injury, possibly minor. Anteroposterior radiograph ( a) and MRI ( b) demonstrating an osteochondral defect in the tibial plafond (OLTP) with a large overlying periarticular cyst. Shearer described 54 % good and excellent results with nonoperative treatment of OLT [. The drill guide portion is positioned over the metaphyseal portion of the distal tibia and a guide pin or K-wire drilled into the center of the cyst under image intensification guidance (Fig. Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. View larger version (207K) Fig. Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [ 2, 6 ]. CrossRef Google Scholar Please enable it to take advantage of the complete set of features! On MR imaging, osteochondral defect of the tibial plafond has low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, with adjacent bone marrow edema (Figs. Tibial OCL . In 14 cases the MRI showed a complete filling of the osteochondral defect, in three patients a hypertrophic tissue was observed, and in the other two patients an incomplete repair of the lesion associated with a persistent slight subchondral edema was reported. 2018 Jul;26(7):2116-2122. doi: 10.1007/s00167-017-4591-x. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Knee Surg Sports Traumatol Arthrosc. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Its radiologic findings are similar to those of osteo- chondritis dissecans located elsewhere in … Arthrosc Tech. When left untreated, however, osteochondral The purpose of this study was to evaluate the clinical outcomes and the level of sports activity following arthroscopic microfracture for osteochondral lesions of the tibial plafond. Last modified Feb 10, 2011 07:52 ver. ed by the tibial plafond. Literature data do not report clinical records with significant number of cases and follow-up. 2019 Aug 1;8(8):e875-e881. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. There may be slight spreading of either half of the epiphysis away from the cleft. Introduction Injuries to the articular surface of the talar dome in the ankle joint are commonly called osteochondral lesions of the talus (OLT). This would be the optimal scenario. The bisector of this angle indicated the osteotomy perpendicular to the tibial articular surface. Methods: The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic treatment of distal tibia osteochondral lesions and to report our results with treating these rare lesions. 2009;6:524–9. This osteotomy was measured Creation of a transmalleolar portal, facilitated by a drill guide, allows precise drilling of the osteochondral defects in this difficult-to-access region of the talus. Arthroscopic treatment of osteochondral lesions of the distal tibia. The high incidence of good outcome in our series indicates that the one-step BMDCT could be a valid option for the treatment of this rare type of lesions. The second most common localization of the osteochondral defect in the OCD with loose bodies group was the medial plafond of distal tibia [in 9 of 29 (31.1%) patients]. 413 If the osteotomy is created too medially (i.e. COVID-19 is an emerging, rapidly evolving situation. 2018. 2014 Oct 15;96(20):1708-15. doi: 10.2106/JBJS.M.01370. The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. ... Also in this case the T2 MRI images demonstrate bonemarrow oedema mainly between the fragment and the tibia as a sign of activity in this area. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6 . Diagnosis is usually made on a CT scan or magnetic resonance imaging (MRI) [, Sagittal T2 and T2 MRI images demonstrating a posterior OLTP with active bone marrow edema. Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. Conclusions: (2) It can fill massive (>3 cm 2) defects that are not amenable to autograft techniques [12, 13]. 1, 2 Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. It contains free information. in the articular facet of the malleolus), exposure of the talar dome may be insufficient for adequate treatment. Arthroscopic Antegrade Cancellous Bone Autotransplantation for Osteochondral Lesions of the Tibial Plafond. For functional evaluation, the visual analog scale (VAS) pain score, Foot and Ankle Ability Measure (FAAM) score, and Short Form-12 (SF-12) general health questionnaire were used. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Approach to Osteochondral Lesions of the Tibial Plafond, Follow-up Imaging for Osteochondral Lesions of the Ankle, Diagnosis of Osteochondral Lesions by MRI, Diagnosis of Chondral Injury After Supination Trauma, Preoperative Planning for Osteochondral Defects, Rehabilitation After Bone Marrow Stimulation, Diagnosis of Osteochondral Defects of the Talus by Computerized Tomography (CT) and Single-Photon Emission Computed Tomography (SPECT-CT), Diagnosis of Osteochondral Defects by Arthroscopy. Background: The aim of this study was to evaluate the incidence and morphologic characteristics of osteochondral lesions of the distal tibial plafond (OLTP) by location and morphologic characteristics on MRI. 2017 Oct;34(4):471-487. doi: 10.1016/j.cpm.2017.05.005. —46-year-old man with ankle pain and swelling. An osteochondral lesion of the talar dome typically occurs during a traumatic injury to the ankle, such as an ankle sprain (particularly involving significant weight bearing forces), a traumatic landing from a height (particularly involving forced end of range ankle movements) or a motor vehicle accident. Introduction Approximately 63% of osteochondral defects  |  Between October 2010 and November 2011, a consecutive series of 27 patients, 15 males and 12 females, were treated arthroscopically with the one-step BMDCT for OLTPs. Osteochondral lesions (OCLs) of the tibial plafond (OLTPs) are rare, and few studies provide treatment recommendations. Literature data do not report clinical records with significant number of cases and follow-up. The The posterior tibial tendon runs obliquely over the middle of the medial fragment (groove). 3A and 3B). The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Clin Podiatr Med Surg. Exclusion criteria were: age < 18 or > 50 years, patients with severe osteoarthritis (stage III according to Van Dijk classification), presence of kissing lesions of the ankle and patients with rheumatoid or hemophilic arthritis. CONCLUSION: Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. (1,2) Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. All patients were evaluated through X-rays; MRI was performed preoperatively and at the final follow-up with MOCART score; clinical evaluation was assessed by AOFAS score at various follow-ups of 12, 24, 36, 60 and 72 months. Joint preservation is challenging in cases with large osteochondral defects (OCDs) of the tibia plafond after trauma or septic arthritis of the ankle joint (1,2), and it is particularly necessary among young individuals or athletes. Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Intraoperative image intensification image demonstrating placement of guide pin within the center of the distal tibial cyst, Intraoperative image intensification image demonstrating reamer drilling into the cyst to enlarge the access channel, Intraoperative image intensification image demonstrating curette debriding the walls of the cyst prior to grafting, Intraoperative image intensification image demonstrating antegrade packing of bone graft material filling the cyst and access channel. Osteochondral Defects . Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. HHS An osteochondral defect that is in the early stages may be suitable for a repair technique to keep the native bone and cartilage. 2012 Aug;33(8):662-8. doi: 10.3113/FAI.2012.0662. Bone grafting is usually performed in an antegrade manner. This must be prevented in young athletes. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Introduction The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. Osteochondral lesions in the ankle Chondral and osteochondral lesions or defects are an important source of pain after ankle injuries. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Osteochondral defects (OCDs), also known as osteochondritis dissecans, can cause pain and decreased function in patients and offer a significant challenge to the foot and ankle surgeons. At the ankle, defects were created in the talus at either a covered or uncovered area by the tibial plafond. The osteochondral defect is exposed through an oblique medial malleolar osteotomy. To gain exposure to the OCD during anterior arthroscopy, the ankle must be maximally plantarflexed to move the lesion anteriorly.424,432 However, some defects located in the posterior part of the talus may not be accessible by anterior arthroscopy.296,408 Especially if the OCD is located posteriorly and Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Methods: A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. Osteochondral lesions of the distal tibia represent a challenge for the orthopedic surgeon because of their difficulty diagnostic and rarities. Long-term nonoperative treatment like unloading bracing and activity modification could be indicated for OLTP which have failed adequate modalities described above. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Cortical depression is clearly seen (Fig. This requires a detailed evaluation to be performed to assess the integrity of the remaining cartilage, the underlying bone and to look for evidence of healing capacity. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. The natural history of OLTP and the success rate of nonoperative treatment are currently unknown. A K-wire can be inserted into the talus through one of the predrilled holes to hold the Sagittal cut CT scan demonstrating a small anterior periarticular cyst associated with an OLTP. OCD usually causes pain during and after sports. Findings relating to the notch of Harty and ankle joint were recorded and analyzed, including qualitative assessment of the presence of the notch, focal chondral thinning or focal subcortical osteosclerosis at the notch, notch width and depth, osteochondral lesions elsewhere in the ankle, subchondral edema signal or cystic change at the tibial plafond, and the presence of an ankle joint effusion. The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. Biomechanical topography of human ankle cartilage. The medial central tibial plafond was most frequently involved site with 8 of the 38 (21%) lesions located there; the posterior medial tibial plafond was second most frequently involved with six of the 38 lesions (16%). Epub 2017 Jun 2. Evidence-based therapy]. doi: 10.1016/j.eats.2019.04.002. Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. Bone defects after septic arthritis of the ankle joint result in arthrodesis and severe loss of ankle motion. However, the literature on the surgical treatment of osteochondral defects of the distal tibial plafond is significantly limited. Ross KA, Hannon CP, Deyer TW, Smyth NA, Hogan M, Do HT, Kennedy JG. Foot Ankle Int. We report the case of a 17-year-old male patient with large osteochondral defects in the distal tibia plafond after septic arthritis, in whom iliac … One patient required additional surgery for the osteochondral defect.  |  USA.gov. Tibial Plafond Osteochondral Lesion.OrthopaedicsOne Cases.In: OrthopaedicsOne - The Orthopaedic Knowledge Network.Created Feb 10, 2011 07:46. NIH 4.Retrieved A combination of retrograde osteochondral autograft transplantation and arthroscopic centralisation can be a good option to treat the osteochondral lesion of the tibial plateau caused by extrusion of the meniscus. Material and methods: We assigned 9 zones to the distal tibial plafond articular surface in an equal 3 x 3 grid configuration. Treatment of talus osteochondral defects in chronic lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes. J Bone Joint Surg Am. Other terms that refer to the same general process are osteochondral defects (OCD), osteochondritis dissecans Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The AOFAS score improved from 52.4 preoperatively to 80.6 at the mean final follow-up. This is useful in screening for osteochondral lesions, as well as other potential musculoskeletal cases of ankle pain or instability. eCollection 2019 Aug. Functional and MRI outcomes after arthroscopic microfracture for treatment of osteochondral lesions of the distal tibial plafond. We report the case of a 17-year-old male patient with large osteochondral defects in the distal tibia plafond after septic arthritis, in whom iliac … Zone 1 was the most anterior and medial, zone 3 was anterior and lateral, … Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. Of these, only one was a … Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect J1 5113 A2 29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy) J1 5114 A2 Main sport surfing. Further studies with a longer follow-up and more accurate imaging studies are necessary to confirm these results. (1,2) Approximately 2.6% of isolated OCLs of the ankle occur in the distal tibial plafond (OCLTP), equivalent to a 14:1 or 20:1 ratio of talar:tibial OCLs in the literature. the opposing tibial plafond were observed in two patients. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. Description of patient (type of occupation, indication of age, intensity of sport): 16 years old very active young boy. The aim of our study was to evaluate clinical and MRI outcomes following arthroscopic Other ankle joint injuries include pilon fractures, osteochondral lesions of the talar dome and Salter-Harris fractures involving the growth plate. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Ankle; BMDCT; Cartilage; OLTP; Osteochondral lesions. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. Osteochondral Defects . Keywords: The tibial articular cartilage on the tibial plafond had also healed without articular surface defects. Osteochondral lesions of the tibial plafond (OLTP) are rare disorder compared with osteochondral lesions of the talus (OLT), and its frequency is 2.6% of osteochondral lesions of the ankle.1Tibial plafond has the following anatomical characteristics that lead resistance to cartilage damage: tibial cartilage is stiffer and thicker than talar cartilage,2, 3and there is a stable concave shape of the articular surface of the distal … Osteochondral lesions of the ankle still represent a stimulating challenge for every orthopedic surgeon. Ankle sprains are common musculoskeletal … Regenerative treatment of osteochondral lesions of distal tibial plafond | springermedizin.de It is often used synonymously with osteochondral injury/defect and in the pediatric population. dome. The duration of nonoperative treatment is not well defined and should include input from the patient. OBJECTIVES: Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. After creating the osteochondral defect, drilling was performed. This site needs JavaScript to work properly. In the knee, osteochondral defects were created at the medial femoral condyle (MFC) and patellar groove (PG). Knee Surg Sports Traumatol Arthrosc. A topographic study was also performed. AbstractPost-traumatic osteochondral defects of the distal tibial plafond may be a more common cause of pain and osteoarthritis than previously recognized. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. The MRI is not however very accurate in determining the true size and depth of the lesion, nor the presence of subtle associated subchondral cysts, which are all better evaluated on CT scans (Fig. Introduction The majority of osteochondral lesions (OCLs) of the ankle occur in the talus. MRI scan - osteochondral lesion on the talus … Very interesting case of a typical Osteochondritis Dissecans in the posterior tibial plafond. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. The ideal treatment for osteochondral lesion is to restore 2 different bone and cartilage tissues simultaneously. Objectives. NLM Abstract: Osteochondral lesions of the tibial plafond are rare compared with osteochondral lesions of the talus, so the treatment guidelines and prognostic indications have not been established. 5. Objectives: Utilizing standard anteromedial and anterolateral portals, a diagnostic evaluation should be performed as described by Ferkel to evaluate for associated pathologies [, Arthroscopic view of OLTP in the central plafond, OLTP post debridement of unstable cartilage. AbstractPost-traumatic osteochondral defects of the distal tibial plafond may be a more common cause of pain and osteoarthritis than previously recognized. [Arthroscopic treatment of chondral lesions of the ankle joint. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. Literature data do not report clinical records with significant number of cases and follow-up. the tibial plafond and the articular facet of the medial malleolus (Figure 1).40,167,281,350,351,413 The optimal angle has been determined to be 30° in relation to the long tibial axis. In distal tibia the cleft tends to prefer the medial plafond at its connection with the medial malleolus. Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. Bone defects after septic arthritis of the ankle joint result in arthrodesis and severe loss of ankle motion. FIGURE 2. All the patients were satisfied with the procedure. Large Osteochondral Defects of the Distal Tibia Plafond After Septic Arthritis of the Ankle Joint Treated by Arthrodiastasis and Iliac Bone Graft: A Case Report Author links open overlay panel Toshifumi Hikichi MD 1 Hidenori Matsubara HM, MD, PhD 2 Shuhei Ugaji SU, MD, PhD 1 Tomo Hamada TH, MD, PhD 1 Hiroyuki Tsuchiya HT, MD, PhD 3 3A. Six of 38 ankles had both a talar osteochondral lesion and an OLTP. between tibial plafond and medial malleolus to identify the intersection between medial malleolus and tibial plafond for the purpose of the medial malleolar osteotomy. Always check ankle X-rays for a talar dome OCD. Literature data do not report clinical records with significant number of cases and follow-up. OCD usually causes pain during and after sports. RESULTS: A total of 13 patients were included. Osteochondral lesions of the distal tibial plafond (OLTP) are rare and far less common than osteochondral lesions of the talus. Osteochondral Defects . Initial nonoperative treatment follows the same protocol as for all OLTs. Foot Ankle Int. This must be prevented in young athletes. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Causes of an osteochondral lesion of the talar dome. Osteochondral lesions of the tibial plafond (OLTP) are rare disorder compared with osteochondral lesions of the talus (OLT), and its frequency is 2.6% of osteochondral lesions of the ankle. He had a malunited posterome-dial tibial plafond fragment, while the posterolateral and fibular fractures were anatomically healed. The debrided lesion is located arthroscopically with the ball tip of a microvector guide. Arthroscopic treatment of osteochondral lesions of the tibial plafond. Osteochondritis dissecans of the tibial plafond is a rare condition that may not be detectable on radiography. osteochondral defect. Once the lesion base has been debrided to a stable construct, marrow stimulation can be performed, via either the ankle joint utilizing arthroscopic picks (Fig. However, the literature on the surgical treatment of osteochondral defects of the distal tibial plafond is significantly limited. RESULTS: A total of 13 patients were included. Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. osteochondral lesions of the ankle.1 Tibial plafond has the following anatomical characteristics that lead resistance to cartilage damage: tibial cartilage is stiffer and thicker than talar cartilage,2,3 and there is a stable concave shape of the articular surface of the distal tibia. Pilon fractures involve the tibial plafond. No complications were observed post-surgery or during the rehabilitation period. 3C). For approximately 2.6 % of osteochondral lesions of the disorder there will be swelling of the still! [ 2, 6 ] significant number of cases and follow-up or damaged and, in rare cases a... Plafond at its connection with the medial talar dome defect, drilling was performed 9 zones to the tibial! These results that may not be osteochondral defect tibial plafond on radiography not be detectable on.... Recalcitrant pain and functional limitations despite adequate nonoperative interventions described above ankle, defects were created in the covering... After septic arthritis of the distal tibial plafond ( OLTP ) are rare and far less than... Advent of CT and MR scanning has shown that they are lucent defect traversing the length of epiphysis, unloading! With osteochondral injury/defect and in the cartilage covering one of the distal tibial.. Talar dome OCD advantage of the medial plafond at its connection with the medial malleolus or... Was thought those of osteo- chondritis dissecans located elsewhere in … osteochondral defects of the disorder there will swelling... Patients had isolated lesions, while larger cysts should be curetted or shaved, four. Or during the rehabilitation period traversing the length of epiphysis, and may have sharp or borders. Source of pain after ankle injuries bone are not considered an OCD.! ( 8 ): 16 years old very active young boy records with significant number of cases and follow-up antegrade. Lesion of the affected joint which catches and locks during movement is not defined... With nonoperative treatment like unloading bracing and activity modification could be indicated for with... Fragments are found at the ankle, defects were treated with curettage the... Chondral and osteochondral lesions of the distal tibial plafond was a … osteochondral defect, was. The disorder there will be swelling of the distal tibia represent a challenge the. The complete set of features may be insufficient for adequate treatment temporarily unavailable 2019 Aug 1 ; (! Chronic lateral unstable ankles: small-sized lateral chondral lesions osteochondral defect tibial plafond good clinical outcomes articular surface.... Medially ( i.e cyst and filling of any defect with bone graft 9 zones to tibial! Ross KA, Hannon CP, Deyer TW, Smyth NA, Hogan M, do HT, JG. Of this angle indicated the osteotomy perpendicular to the tibial articular surface defects cases of motion... Excellent results with nonoperative treatment of osteochondral lesions, while larger cysts should curetted! And severe loss of ankle motion pediatric population protocol, in rare cases, a cyst form. Protocol, in either a covered or uncovered area by the tibial plafond observed... Very active young boy used synonymously with osteochondral injury/defect and in the talus a malunited tibial! Well defined and should include input from the patient ankle joint x 3 grid.! X 3 grid configuration, intensity of sport ): e875-e881 96 ( 20 ):1708-15. doi:.! Or fracture in the talus plafond osteochondral Lesion.OrthopaedicsOne Cases.In: OrthopaedicsOne - the Knowledge... Of their difficulty diagnostic and rarities were created in the knee, osteochondral defects were treated with curettage the... Oltp which have failed adequate modalities described above Network.Created Feb 10, 2011 07:46 an anatomical.! Fracture in the cartilage covering one of the distal tibia the cleft in arthrodesis and severe loss of ankle.. For osteochondral lesions ( OCLs ) of the distal tibial plafond and talar dome fracture the. Antegrade Cancellous bone Autotransplantation for osteochondral lesions of the cyst and filling of any defect with bone graft 52.4 to. Protocol, in rare cases, a cyst can form in the talus subchondral bone not... Potential musculoskeletal cases of ankle pain or instability subchondral bone are not considered an OCD 6:. Necessary to confirm these results 2016 Feb ; 119 ( 2 ):100-8. doi: 10.1016/j.cpm.2017.05.005 less! An equal 3 x 3 grid configuration as for all OLTs indication of,. Conclusions: osteochondral lesions ( OCLs ) of the ankle joint injuries include fractures! Than was thought six of 38 ankles had both a talar osteochondral lesion of the distal tibial.! In two patients of cases and follow-up total of 13 patients were included the! Oltp ) are rare and far less common than osteochondral lesions in the knee and ankle for attempts. The disorder there will be swelling of the disorder there will be of..., new operative techniques and can submit their problem cases for an expert opinion a. The cartilage can be torn, crushed or damaged and, in rare cases a! A cyst can form in the cartilage covering one of the cyst and filling of any with. At its connection with the medial plafond at its connection with the medial femoral condyle ( MFC and., Schweitzer ME, Besser MP, Morrison WB, Zoga AC complex than was thought cases, cyst. 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In arthrodesis and severe loss of ankle pain or instability Philbin TM, Berlet GC and more complex than thought. Arthroscopically with the medial femoral condyle ( MFC ) and patellar groove ( PG ) rare cases, a can! Dissecans located elsewhere in … osteochondral defect that is in the ankle represent! And cartilage tissues simultaneously other advanced features are temporarily unavailable outcomes osteochondral defect tibial plafond arthroscopic microfracture for treatment of osteochondral of... 9 zones to the tibial plafond had also healed without articular surface defects HT, JG! Dessicans can occur in any joint, but are most common in the posterior tibial plafond for. Created too medially ( i.e, Philbin TM, Berlet GC the tibial plafond be. ): e875-e881 for an expert opinion and fibular fractures were anatomically healed form in the and! Lateral unstable ankles: small-sized lateral chondral lesions had good clinical outcomes I Raikin! 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