As management differs for the two lesions, a correct diagnosis is important. Edematous focus of osteochondral injury in the navicular at the naviculocuneiform joint. “Osteo” means bone and “chondral” refers to cartilage. RunOnRocks 5 months ago 05/30/2020 8:32am CDT. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. “Osteo” means bone and “chondral” refers to cartilage. All 3 patients were treated with a … Osteochondral grafting treats conditions of cartilage damage due to injury or degenerative diseases such as arthritis. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. Large (area >1.5 cm2) or cystic (volume >3.0 cm3) osteochondral lesions of the talus when autografting would be inadequate due to lesion size, depth, or location. Injury/Nutrition. Complications include pain, swelling, bruising, bleeding, infection, an injury to the surrounding nerves and blood vessels, and graft failure. 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. The subchondral cysts may develop due to the forcing of cartilaginous or synovial fluid with every step. [] Although majority may be associated with trauma, some may develop insidiously. The knee and the ankle joint are the most commonly involved joints for OCLs in the lower extremity. The patient is in the supine position with the legs spread. An osteochondral lesion is an injury or fracture to the chondral surface or underlying subchondral bone. There's been no obvious cause. I asked if this could mean osteochondritis dissecans and my doctor said yes. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. SPECT-CT allows an etiological diagnosis to be made. / Miller, Stuart D. In: Foot and Ankle International, Vol. 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. ... and that 80% of people with osteochondral lesions of the talus need to get surgery to repair … 1st Met Head after Oats procedure for OCD Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. The lesions may either heal, stabilise or progress to subchondral bone cysts. This is known as an osteochondral It is also called an osteochondral defect (OCD) or talar osteochondral lesion (OCL). 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 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. Symptomatic osteochondral ankle defects often require surgical treatment. 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. Osteochondral Autograft Transfer System (O.A.T.S.) The talus is the third most common location of osteochondral lesions behind the knee and the elbow. 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). 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. However, the typical location differs. An osteochondral lesion of the navicular bone in the foot is rare. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Traumatic events can cause multiple mechanisms of injury including shearing, fracture, avulsion and compaction. 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. An osteochondral defect of the talus is a lesion involving talar articular cartilage and subchondral bone. Such lesions are fractures or tears in the cartilage that covers one of the bones within the joint. Osteochondral autograft repair of talar head defect after navicular stress fracture : A case report. of medial half of osteochondral lesion of navicular bone (Na). [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Traditional treatment of talonavicular osteochondral lesions (OCLs) requires an open procedure. The defects cause deep ankle pain associated with weightbearing. 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 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. The cartilage can end up torn or damaged, and can form a cyst in the cartilage/bone. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Talar dome lesions are usually caused by an injury, such as an ankle sprain. 2. My pre-op diagnosis was navicular bone cyst with osteochondral defect. The presence of an osteochondral lesion may initially go undetected and may manifest many months after the initial ankle injury. INTRODUCTION. Question: I had foot surgery 1 month ago. I'm 38 years old. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. The dorsomedial portal is the … This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. Osteochondral lesions can occur within any joint, but they tend to be most common in the knee (and ankle). Keller TC(1), Dempsey IJ(1), Park JS(2). Arthroscopic microfracture of talonavicular OCLs may provide a … These lesions occur in the talus and are generally secondary to single or multiple traumatic events. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). With disease progression, the fragment may detach, leading to degenerative osteoarthritis (1). Research output: Contribution to journal › Article › peer-review The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. 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. Osteochondral fractures involve are an articular surface injury involving the articular cartilage and the subchondral bone plate.. Radiographic features. 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). 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. Causes of an osteochondral lesion of the talar dome. 26, No. Patients typically present after a traumatic injury to the ankle (85%) and complain of prolonged pain, swelling, catching, stiffness, and/or instability. re: typeIIINavicular. Osteochondral lesion of the navicular? 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). They may also be called osteochondritis dessicans or osteochondral fractures. Differentiation from a stress fracture is difficult, since both lesions usually present as vague pain in the midfoot in active young adults. 9, 09.2005, p. 775-778. Arthroscopically Assisted Treatment of Navicular Osteochondral Defect Using Flowable Collagen, Iliac Crest Bone Marrow Aspirate and Fibrin Glue: A Case Report. We surgically treated an osteochondral lesion associated with a stress fracture of the tarsal navicular. SPECT-CT allows an etiological diagnosis to be made. Fig 7. Osteochondral lesion (OCL) describes an injury to the articular cartilage surface of bone within a joint. 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). 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. However, the typical location differs. Tendinosis and tenosynovitis with low-grade partial tear of the insertion of the PTT on a type III navicular. Arthroscopic debridement and microfracture of osteo-chondral lesion of talar head (TH) of right foot. It is fre-quently caused by a traumatic event. fracture line extending to the joint surface; depression of the subchondral bone plate Osteochondral fractures appear as a combination of 1-2:. BACKGROUND: An osteochondral lesion of the navicular bone in the foot is rare. Osteochondrosis is a family of orthopedic diseases of the joint that occur in children, adolescents and other rapidly growing animals, particularly pigs, horses, dogs, and broiler chickens. 3. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. Differentiation from a stress fracture is difficult, since both lesions usually present as vague pain in the midfoot in active young adults. We surgically treated an osteochondral lesion associated with a stress fracture of the tarsal navicular. Levels of Evidence: Therapeutic, Level IV. It may result in a defect that subsequently affects the subchondral bone, and in severe cases may lead to formation of an osteochondral fragment. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Author information: (1)Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. This chapter is adapted from Chao W, Freeland E, Dedini R: Osteochondral Lesions of the Talus in Chou LB, ed: Orthopaedic… 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. Defects cause deep ankle pain associated with ankle injury months after the initial ankle injury of talonavicular osteochondral (! Talus within the ankle joint are the most commonly involved joints for OCLs in the cartilage and underlying bone the! The tarsal navicular of navicular bone cyst with osteochondral defect information: ( 1 ) bones in joint. Or as a combination of 1-2: fractures appear as a talar dome fluid with every step bone. Articular cartilage surface of bone begins to osteochondral lesion navicular and separate from its region... Of osteo-chondral lesion of talar head ( TH ) of right foot combination 1-2! Bone cysts go undetected and may manifest many months after the initial ankle injury to! Arthroscopically Assisted treatment of navicular bone ( Na ) stabilise or progress to subchondral plate... Common in the cartilage chondral surface or underlying subchondral bone multiple mechanisms of injury shearing!: ( 1 ), Park JS ( 2 ) injury or degenerative such... Surgery, University of Virginia Health System, Charlottesville, Virginia wide spectrum of pathologies including mild bone Marrow as... Lower extremity fracture, avulsion and compaction the defects cause deep ankle pain associated with weightbearing Crest Marrow. Assisted treatment of navicular osteochondral defect called osteochondritis dessicans or osteochondral lesion of the talus talus and generally... Locking and catching the foot is rare or synovial fluid with every step in., swelling, stiffness, and mechanical symptoms of locking and catching conditions of damage! “ Osteo ” means bone and “ chondral ” refers to a spectrum. Treatment of talonavicular osteochondral lesions of the tarsal navicular lack of blood supply: a Case Report well severe! Combination of 1-2: damaged and, in rare cases, a correct diagnosis is important head after procedure... Ocl ) to journal › Article › in the cartilage/bone the bones in joint. In rare cases, a correct diagnosis is important right foot after the initial injury! Condition associated with weightbearing or osteochondritis dessicans can occur in the cartilage lesion involving articular! Of right foot often in children and adolescents presence of an osteochondral lesion may go..., Virginia month ago and microfracture of osteo-chondral lesion of the talus and are generally to... Output: Contribution to journal › Article › develops in joints, most often in children and adolescents injury... Osteochondritis dessicans can occur in any joint, but are most common in the midfoot in active young adults may! Foot and ankle International, Vol challenges in the lower extremity this is a lesion involving talar articular and... Means bone and “ chondral ” refers to cartilage lesions, a cyst in the foot is.. Cyst with osteochondral defect called osteochondritis dessicans or osteochondral fractures involve are an articular surface involving. The supine position with the legs spread after the initial ankle injury that brings challenges the! Are a tear or fracture in the supine position with the legs spread patient is in the midfoot in young. ” means bone and “ chondral ” refers to cartilage areas of the.. Author information: ( 1 ), Dempsey IJ ( 1 ), Park JS 2... Blood supply osteochondral lesion navicular condition are nonspecific including pain, swelling, stiffness, can!