of medial half of osteochondral lesion of navicular bone (Na). An osteochondral defect of the talus is a lesion involving talar articular cartilage and subchondral bone. The subchondral cysts may develop due to the forcing of cartilaginous or synovial fluid with every step. Osteochondral Autograft Transfer System (O.A.T.S.) Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. Osteochondral lesions (OCLs) are focal articular injuries of the subchondral bone and the cartilage with a multifaceted cause (trauma, ligament instability, ischemic necrosis, malalignment, endocrine diseases, and others). [] Although majority may be associated with trauma, some may develop insidiously. SPECT-CT allows an etiological diagnosis to be made. With disease progression, the fragment may detach, leading to degenerative osteoarthritis (1). 3. Osteochondral fractures involve are an articular surface injury involving the articular cartilage and the subchondral bone plate.. Radiographic features. Edematous focus of osteochondral injury in the navicular at the naviculocuneiform joint. 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. / Miller, Stuart D. In: Foot and Ankle International, Vol. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. Keller TC(1), Dempsey IJ(1), Park JS(2). The presence of an osteochondral lesion may initially go undetected and may manifest many months after the initial ankle injury. Osteochondral lesions can occur within any joint, but they tend to be most common in the knee (and ankle). Question: I had foot surgery 1 month ago. It may result in a defect that subsequently affects the subchondral bone, and in severe cases may lead to formation of an osteochondral fragment. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). SPECT-CT allows an etiological diagnosis to be made. fracture line extending to the joint surface; depression of the subchondral bone plate The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. My pre-op diagnosis was navicular bone cyst with osteochondral defect. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Arthroscopic microfracture of talonavicular OCLs may provide a … Author information: (1)Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. Research output: Contribution to journal › Article › peer-review Differentiation from a stress fracture is difficult, since both lesions usually present as vague pain in the midfoot in active young adults. An osteochondral lesion of the talar dome is an injury to the talus, which is a bone in the foot that along with the tibia forms the ankle joint. They may also be called osteochondritis dessicans or osteochondral fractures. Revision surgery after failed prior marrow stimulation for large (area >1.5 cm2) or cystic (volume >3.0 cm3) osteochondral lesions of the talus when autografting would be Osteochondral lesions typically occur following ankle injury or sprains, particularly if the injury was the result of jumping, which places an excessive compressive force between the talus and the tibia. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. “Osteo” means bone and “chondral” refers to cartilage. Postoperatively, my surgeon told my spouse he drilled into the top of the navicular bone, evacuated the cyst, and filled the defect with bone marrow. Traumatic events can cause multiple mechanisms of injury including shearing, fracture, avulsion and compaction. Differentiation from a stress fracture is difficult, since both lesions usually present as vague pain in the midfoot in active young adults. This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. The talus is the third most common location of osteochondral lesions behind the knee and the elbow. BACKGROUND: An osteochondral lesion of the navicular bone in the foot is rare. Complications include pain, swelling, bruising, bleeding, infection, an injury to the surrounding nerves and blood vessels, and graft failure. Osteochondral lesions of the talus are a reasonably infrequent cause of long-standing ankle pain and stiffness and are often the result of a severe ankle sprain type injury. Injury/Nutrition. re: typeIIINavicular. 1st Met Head after Oats procedure for OCD An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). We prospectively reviewed 3 cases of osteochondral lesions and degenerative changes of the tarsal navicular joint involving a unique surgical approach consisting of microfracture of the lesions with concomitant arthrodiastasis. Symptomatic osteochondral ankle defects often require surgical treatment. Patients typically present after a traumatic injury to the ankle (85%) and complain of prolonged pain, swelling, catching, stiffness, and/or instability. Talar dome lesions are usually caused by an injury, such as an ankle sprain. We surgically treated an osteochondral lesion associated with a stress fracture of the tarsal navicular. This case report presents an arthroscopically assisted treatment of a navicular osteochondral lesion using curettage and backfilling with fibrin glue, flowable collagen, and autogenous bone grafting. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Osteochondral lesion (OCL) describes an injury to the articular cartilage surface of bone within a joint. The surgical procedure involved the confirmation and complete resection of the lesion under direct vision, followed by the transplantation of block-shaped iliac bone grafts. Levels of Evidence: Therapeutic, Level IV. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. The knee and the ankle joint are the most commonly involved joints for OCLs in the lower extremity. Osteochondral autograft repair of talar head defect after navicular stress fracture : A case report. The defects cause deep ankle pain associated with weightbearing. Intraop pic of cartliage damage inside big toe joint that was cleaned up and then drilled to stimualte cartilage regrowth (below) Intraop Pic before and after subchondral drilling for OCD 1st met head. There's been no obvious cause. Arthroscopic debridement and microfracture of osteo-chondral lesion of talar head (TH) of right foot. We surgically treated an osteochondral lesion associated with a stress fracture of the tarsal navicular. Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. The dorsomedial portal is the … RunOnRocks 5 months ago 05/30/2020 8:32am CDT. 26, No. The lesions may either heal, stabilise or progress to subchondral bone cysts. This chapter is adapted from Chao W, Freeland E, Dedini R: Osteochondral Lesions of the Talus in Chou LB, ed: Orthopaedic… The patient is in the supine position with the legs spread. An osteochondral lesion of the navicular bone in the foot is rare. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. Tendinosis and tenosynovitis with low-grade partial tear of the insertion of the PTT on a type III navicular. 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. Arthroscopically Assisted Treatment of Navicular Osteochondral Defect Using Flowable Collagen, Iliac Crest Bone Marrow Aspirate and Fibrin Glue: A Case Report. It is also called an osteochondral defect (OCD) or talar osteochondral lesion (OCL). An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). 2. These lesions occur in the talus and are generally secondary to single or multiple traumatic events. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. Such lesions are fractures or tears in the cartilage that covers one of the bones within the joint. “Osteo” means bone and “chondral” refers to cartilage. I'm 38 years old. Osteochondral lesion of the navicular? Osteochondral fractures appear as a combination of 1-2:. Fig 7. ... and that 80% of people with osteochondral lesions of the talus need to get surgery to repair … The cartilage can end up torn or damaged, and can form a cyst in the cartilage/bone. They are characterized by interruption of the blood supply of a bone, in particular to the epiphysis, followed by localized bony necrosis, and later, regrowth of the bone. Osteochondral Lesions of the Talus Sara Lyn Miniaci-Coxhead, MD Dr. Miniaci-Coxhead or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. 9, 09.2005, p. 775-778. This is known as an osteochondral It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Traditional treatment of talonavicular osteochondral lesions (OCLs) requires an open procedure. I asked if this could mean osteochondritis dissecans and my doctor said yes. All 3 patients were treated with a … It is fre-quently caused by a traumatic event. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. 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