Osteochondral Lesions of Talus: A Comprehensive Review

Department of Orthopaedic and Trauma Surgery, Viale Regina Margherita, 70022, Altamura (BARI), Italy.

Corresponding Author: Saccomanni Bernardino, Department of Orthopaedic and Trauma Surgery, Viale Regina Margherita, 70022, Altamura (BARI), Italy,Tel: 3208007854; E-Mail: [email protected]

Received Date: 04 Aug 2018  
Accepted Date: 16 Aug 2018  
Published Date: 20 Aug 2018

Copyright © 2018 Saccomanni B

Citation: Saccomanni B. (2018). Osteochondral Lesions of Talus: A Comprehensive Review. Mathews J Orthop. 3(1): 021.

ABSTRACT

Osteochondral lesions of the talus (OLT) present a challenge and optimal treatment remains controversial. Although future randomized clinical trials are needed to establish evidence of the most effective treatment, both reparative and replacement procedures remain feasible options. The literature supports treatment with bone marrow stimulation (BMS) for lesions of smaller sizes, whereas treatment with autologous osteochondral transplantation (AOT) may be utilized for larger or cystic lesions. Cell-based techniques and allograft transplantation may be utilized in failed primary procedures. Although biologic augmentation offers promising results, well-designed clinical trials are necessary to determine efficacy in the clinical setting.

Core tip:Osteochondral lesions of the talus are often missed after acute ankle sprains and fractures. Magnetic resonance imaging is most sensitive in diagnosing these injuries. BMS is effective for lesions < 150 mm2 in area, but replacement procedures such as autologous osteochondral transplantation or allografts may be required for larger lesions or if BMS fails. Long term studies should attempt to determine the most effective treatment strategy and the critical defect strategy beyond which BMS will not work.

Keywords: Osteochondral Lesions of Talus; Comprehensive Review; Diagnosis; Bone Marrow Stimulation; Autologous Autograft Transfer; Biologics.