Radiologic studies revealed evidence of mild hip dysplasia and, in one case, an osteochondral fracture of the right femoral head. Tissue engineering strategies for the knee meniscus and osteochondral tissues as well as optimised tissue engineering scaffolds were also developed. 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 injuries are one of the most common causes of ankle pain. They may also be called osteochondritis dessicans or osteochondral 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. Acute osteochondral injuries of the hip are rare in the absence of associated dislocation. patents-wipo. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. 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. Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. A badly twisted ankle can also cause small pieces of the talus to break off. 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. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. 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. In children and adolescents, many sports related ankle injuries result in physeal fractures. The twist may occur from direct trauma such as a tackle or other impact, or from a fall. Repeated trauma can lead to a more severe osteochondral injury that, in turn, may result in progressive disability [4]. 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… INTRODUCTION. The osteochondral lesions, particularly when the in-jury is minor, are generally not … Injuries that could cause a talus fracture include a fall from a great height or a car accident. 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. If your physician has determined that this is the case, he may recommend rest and physical therapy while he observes your knee's recovery. Fig. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment. One population that has been well studied is the military. More often, there is no clear history of a single injury. Request PDF | Acute Osteochondral Injuries of the Hip | Acute osteochondral injuries of the hip are rare in the absence of associated dislocation. 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. 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. 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. Osteochondral lesions can range from minor cartilage tears to major loose chips of bone and cartilage in your ankle joint. osteochondral fracture of the talus more often than expected [2, 3]. As with similar ankle injuries, an osteochondral fracture is graded 1 to 5 depending on severity or type of injury. It contains free information. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. This injury most frequently occurs during a violent twist to the knee, especially when weight bearing. Most patients are scheduled to visit their physician once every four to six weeks until the osteochondral defect heals. [] Although majority may be associated with trauma, some may develop insidiously. Such lesions also may result from high energy trauma, avascular necrosis, infection and iatrogenic causes. Background: Osteochondral defects represent a main risk factor for osteoarthritis of the ankle. Terminology. 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. 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. Osteochondral Fracture and Patellar Instability Eric J. (1). However, if pain and swelling persist, an osteochondral lesion may be suspected. A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondral defect. Other examples of bone injuries include stress fractures, osteochondral fractures and a variety of different patterns of bone fractures. The joint feels unstable and won’t straighten fully. 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. Members receive the 'Picture of the week', new operative techniques and can submit their problem cases for an expert opinion. 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. Chondral and osteochondral fractures may be associated with other intra-articular pathologies. Ankle Platform is for Orthopedic Surgeons with special interest in Ankle and Hindfoot. Osteochondral defects are focal areas of articular damage with cartilage damage and injury of the adjacent subchondral bone. A series of cases is presented in which these injuries were sustained after relatively minor trauma to the hip. Chondral injuries may accompany an injury to a ligament, such as the anterior cruciate ligament. And in the hip, osteochondral injuries are most often associated with hip dislocation. springer. 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. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. And in the hip, osteochondral injuries are most often associated with hip dislocation. 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. ome minor osteochondral defects can heal on their own, without casting or surgery. 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