44,61,70 Classic teaching is that lateral OLTs are more likely due to trauma than medial lesions, with 94% of lateral lesions and 62% of medial lesions being caused by trauma. Treatment depends on the severity of the talar dome lesion. 1 ) and anterolateral (46%) talar dome ( 1 ). The talar dome is trapezoidal in shape, and its anterior surface is, on average, 2.5 mm wider than the posterior surface. Osteochondral lesions of the talus are an increasingly recognised pathology of the ankle joint and can lead to significant complications if not treated appropriately. An osteochondral lesion of the talar dome is a condition characterized by damage to the cartilage and / or bone surfaces of the upper (superior) aspect of the talus bone (i.e. If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following non-surgical treatment options may be considered: 1. 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. In these cases, the most affected area is the posteromedial talar dome (see Table 71-1). Lateral lesions are located in the middle third of the talar dome and are shallow and wafer- shaped. Talar dome lesions … Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. Trauma is the most common cause, but ischemic necrosis, endocrine disorders, and genetic factors may have etiologic significance. The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. the talar dome) in the ankle. Symptoms of Osteochondral Lesion of the Talus. Most often present with a chief complaint of a sprained ankle. (1,2,3) Talar dome injuries create a focal defect in the dome of the talus that results in injury to the cartilage and underlying bone. Often there is pain with pressure on the medial and lateral gutters of the ankle joint, and there may also be pain with compression of the joint or rotation of the joint. “Osteo” means bone and “chondral” refers to cartilage. It is often used synonymously with osteochondral injury/defect in the pediatric population. Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. 1. Approximately 50% of ankle sprains and up to 73% of ankle fractures result in some level of cartilage injury, and there are over 2 million ankle sprains alone per year. OCD lesions of the elbow are typically found in athletes in the teen years after the physis has closed. non-surgical treatment fails to relieve the symptoms of talar dome One of the best diagnostic tests of an ankle osteochondral lesion of the talus is a diagnostic anesthetic injection of the ankle joint. Talar dome lesions … Appropriate management is therefore vital. The dome of the talus is covered by the trochlear articular surface, which supports the weight of the body. Talar dome lesions … Hereby, the most common reasons are a severe inversion ankle sprain, chronic ankle instability (CAI; causing in 5–9% of the cases a lateral talar OCL), 9, 10 or a fracture mechanism. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. 69% of ankle fractures. Background: Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. This presents as a more challenging condition to treat and can often only be addressed by surgical intervention. Osteochondral lesions of the talar dome are relatively common causes of ankle pain and disability. “Osteo” means bone and “chondral” refers to cartilage. The medial and lateral articular facets of the talus articulate with the medial and lateral malleoli. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage. Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): It is often associated with a traumatic injury, such as a severe ankle sprain. Berndt and Harty proved this in a report in which anteromedial and posterolateral lesions were created using cadavers.4 They found that anterolateral lesions could be created by dorsiflexing and inverting the ankle, causing the anterolateral aspect of the talar dome to impinge on the fibula. The ankle OCD lesion is rare in the pediatric population, mainly occurring in adults with the average age being 21 years of age. ankle to move smoothly.A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint.It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT).“Osteo”means bone and “chondral”refers to cartilage. 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). Other terms used include an osteochondral defect (OCD), osteochondral lesion of the talus (OLT) and osteochondritis dessecans, which are all used interchangeably. There are differing degrees of severity varying from very small undisplaced lesions to those that create large loose bodies and develop cysts in the talus. The most common sites are the posteromedial (53%) ( Fig. However, medial lesions are more common than lateral OCLs. Leaving a talar dome injury untreated commonly results in osteoarthritis changes of the ankle joint, chronic pain and limitations in joint range of motion. The medial lesions tend to be deeper and cup shaped whereas the lateral lesions tend to be thinner and more wafer shaped . A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is currently accepted that OCL of the talus is primarily traumatic in origin. Immobilization – Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. Methods: A professional rugby league player underwent surgery for a complex injury to the ankle. Talar dome lesions usually occur from an injury, such as an ankle sprain. Talar dome fractures are often missed at the initial examination following an ankle sprain or injury. “Osteo” means bone and “chondral” refers to cartilage. Treatment for osteochondral lesions of the talar dome vary depending on the severity of the injury. “Osteo” means bone and “chondral” refers to cartilage. OCD usually causes pain during and after sports. incidence. 66 The mechanism for traumatic impaction of the lateral … Most lesions are trauma-induced, located on the lateral side, and can be diagnosed well by combining a proper history and physical with MRI. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Cause. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. There is an association with trauma to the ankle, particularly in lateral talar dome lesions. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). The treatment given for the sprain or injury usually fails to treat the unidentified fracture. The treatment options are numerous and constantly evolving, with no well-established evidence base to … A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Presentation. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. The result is a persistent deep pain in the ankle and recurrent swelling with activity. Osteochondraldefect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. An osteo-chondral lesion is a defect in the upper surface of the talus that involves bone (osteo) and cartilage (chondral). Also known as a talar dome lesion, this condition causes pain and swelling within the ankle, and left untreated, may lead to long-term damage to the bone. Talar dome injuries result from trauma to the ankle including ankle sprains (6-38% of all ankle sprains), fractures (greater than 70% of all ankle fractures). The vast majority of lateral lesions are associated with a distinct traumatic episode and patients … A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Figure 1 Relevant Anatomy for an Osteochondral Lesion of the Talar Dome If left untreated, osteochondral lesions of the talar dome can develop into arthritis. Symptoms of osteochondral lesions of the talus tend to develop gradually, and … Osteochondral lesions of the talus, or talar dome lesions, can be classified as ischaemic or traumatic injuries and can be debilitating if untreated. Talar dome lesions … Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. When an injury occurs to the cartilage and underlying bone of the talus within the ankle joint it is called a talar dome lesion. Epidemiology. Medial lesions are typically located in the posterior third of the talar dome and are deeper and cup shaped (2). 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