There are two main mechanisms of these fractures, including a direct effect causing avulsion or impaction and, a more common mechanism, flexion-rotation force to the knee, which is also the mechanism for an acute patellar dislocation. Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. Radiologic studies revealed evidence of mild hip dysplasia and, in one case, an osteochondral fracture of the right femoral head. The two most common types of osteochondral lesions are classified according to the part of your talus that is damaged: Anteriorlateral - These lesions affect the outside portion of your talus, usually toward the front. This injury most frequently occurs during a violent twist to the knee, especially when weight bearing. A series of cases is presented in which these injuries were sustained after relatively minor trauma to the hip. It occurs more often in adolescent males. [] Although majority may be associated with trauma, some may develop insidiously. They may also be called osteochondritis dessicans or osteochondral fractures. Request PDF | Acute Osteochondral Injuries of the Hip | Acute osteochondral injuries of the hip are rare in the absence of associated dislocation. The true incidence of osteochondral/chondral fractures in the lower extremity is difficult to determine due to a lack of defined symptoms and radiographic findings at the time of injury. Osteochondral lesions (OCL) of the talus are being recognized as an increasingly frequent sports injury. Materials and methods: A thorough literature search was performed and was supported by personal experience. And in the hip, osteochondral injuries are most often associated with hip dislocation. Injuries that could cause a talus fracture include a fall from a great height or a car accident. More often, there is no clear history of a single injury. A bone bruise is characterised by three different kinds of bone injuries including: sub-periosteal hematoma, inter-osseous bruising and a sub-chondral lesion, or a combination of these. Though in a majority of cases there is a history of injury or trauma to the ankle joint, a few cases may not have any previous history of ankle injury. In children and adolescents, many sports related ankle injuries result in physeal fractures. Microfracture for Osteochondral Lesions of the Talus: Perspective 1 Hajo Thermann Christoph Becher DEFINITION The terminology of osteochondral lesions is not uniform: Transchondral fractures, osteochondral fractures, flake fractures, and osteochondritis dissecans (OCD) are used to describe the same entity. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5.It is often used synonymously with osteochondral injury/defect and in the pediatric population. However, if pain and swelling persist, an osteochondral lesion may be suspected. Osteochondral lesions can range from minor cartilage tears to major loose chips of bone and cartilage in your ankle joint. The true incidence of osteochondral/chondral fractures in the lower extremity is difficult to determine due to a lack of defined symptoms and radiographic findings at the time of injury. This can occur in any joint, although it is most common in the knee (especially the kneecap), followed by the ankle, elbow, and shoulder. 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. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment. A badly twisted ankle can also cause small pieces of the talus to break off. The condition occurs most commonly in the knee, but also occurs in elbows, ankles and other joints. The twist may occur from direct trauma such as a tackle or other impact, or from a fall. The true incidence of osteochondral/chondral fractures in the lower extremity is difficult to determine due to a lack of defined symptoms and radiographic findings at the time of injury. If your physician has determined that this is the case, he may recommend rest and physical therapy while he observes your knee's recovery. springer. Fig. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. Wall Shital N. Parikh INTRODUCTION Pathogenesis An osteochondral injury can occur in up to 71% to 93% of patients during an acute patellar dislocation.1,2 The chondral and osteochondral injury can vary from minor cartilage scuffing or fissuring, to large full-thickness free fragments greater than 3 cm diameter or… [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Chondral injuries may accompany an injury to a ligament, such as the anterior cruciate ligament. Acute osteochondral injuries of the hip are rare in the absence of associated dislocation. Chondral osteochondral defect, a knee injury, causing pain, swelling, and catching of the joint. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. And in the hip, osteochondral injuries are most often associated with hip dislocation. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. These injuries may include softening of the cartilage layers, cyst-like lesions within the bone below the cartilage, or fracture of the cartilage and bone layers. ome minor osteochondral defects can heal on their own, without casting or surgery. An osteochondral lesion of the talus is often missed during the early diagnosis of ankle injuries, since an injury such as a sprain is usually considered minor and does not require treatment. Acute osteochondral injuries of the hip are rare in the absence of associated dislocation. The methods and compositions provide an effective amount of isolated differentiable human Very Small Embryonic Like Stem Cells (hVSELs) sufficient for regeneration or repair of an osteochondral tissue. Repeated trauma can lead to a more severe osteochondral injury that, in turn, may result in progressive disability [4]. Background: Osteochondral defects represent a main risk factor for osteoarthritis of the ankle. (1). It can cause symptoms either after an injury to a joint or after several months of activity, especially high-impact activity such as jumping and running, that affects the joint. Osteochondral Fracture and Patellar Instability Eric J. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. Chondral and osteochondral injuries are relatively common in the weightbearing joints of the lower extremity. INTRODUCTION. Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Keywords: Osteochondral defects, arthroscopic debridement, micro fracture technique, lysholm knee scoring scale Introduction Articular cartilage is a complex tissue with an ability to withstand tremendous forces over many cycles and years, but at the same time it has no ability to heal even after a minor injury. As with similar ankle injuries, an osteochondral fracture is graded 1 to 5 depending on severity or type of injury. Radiologic studies revealed evidence of mild hip dysplasia and, in one case, an osteochondral fracture of the right femoral head. One population that has been well studied is the military. A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondral defect. I – Subchondral fracture. Most patients are scheduled to visit their physician once every four to six weeks until the osteochondral defect heals. The joint feels unstable and won’t straighten fully. Excessive forces applied tothe skeletally immature ankle … Terminology. Osteochondral injuries are one of the most common causes of ankle pain. The pathology can range from a simple contusion of the articular cartilage and subchondral bone to a fracture involving the cartilage alone or cartilage and underlying subchondral bone together. Small pieces of the articular cartilage can actually break off and float around in the knee as loose bodies, causing locking, catching, and/or swelling. Such lesions also may result from high energy trauma, avascular necrosis, infection and iatrogenic causes. Chondral and osteochondral injuries to the humeral head are common in the setting of shoulder instability and often contribute to recurrent instability. A series of cases is presented in which these injuries were sustained after relatively minor trauma to the hip. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Chondral and osteochondral fractures may be associated with other intra-articular pathologies. Tissue engineering strategies for the knee meniscus and osteochondral tissues as well as optimised tissue engineering scaffolds were also developed. And in the hip, osteochondral injuries are most often associated with hip dislocation. It contains free information. patents-wipo. Osteochondral defects are focal areas of articular damage with cartilage damage and injury of the adjacent subchondral bone. Objectives: The aim of this article is to provide an overview of current optimal clinical cartilage imaging techniques of the foot and ankle and to show typical osteochondral injuries on imaging. osteochondral fracture of the talus more often than expected [2, 3]. Osteochondral fracture is a localized injury affecting a surface of the joint that involves breaking, with or without separation, a segment of cartilage and the underlying bone. Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. Fig. Other examples of bone injuries include stress fractures, osteochondral fractures and a variety of different patterns of bone fractures. The osteochondral lesions, particularly when the in-jury is minor, are generally not … Avascular necrosis, infection and iatrogenic causes their own, without casting or surgery as the anterior ligament. 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