Current Updates in Treatment of Osteochondral Lesions of the Talus

Young Hwan Park; Jae Young Kim; Hak Jun Kim

doi:10.14193/jkfas.2019.23.2.43

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Park, Kim, and Kim: Current Updates in Treatment of Osteochondral Lesions of the Talus

Review Article

Journal of Korean Foot and Ankle Society 2019; 23(2): 43-51.

Published online: 14 June 2019

DOI: https://doi.org/10.14193/jkfas.2019.23.2.43

Current Updates in Treatment of Osteochondral Lesions of the Talus

Young Hwan Park, Jae Young Kim, Hak Jun Kim

Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.

Corresponding Author: Hak Jun Kim. Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea. Tel: 82-2-2626-3090, Fax: 82-2-2626-1163, dakjul@hanmail.net

Received 9 April 2019 Revised 8 June 2019 Accepted 8 June 2019

Korean Foot and Ankle Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Despite the increasing number of osteochondral lesions of the talus, there are a lack of definite evidence-based treatment protocols. Several types of treatments are available, each having their advantages and disadvantages. First-line therapy consists of well-conducted conservative treatment. Surgical treatment is the second choice. Treatments are chosen based on the size of the lesion, location, chronicity, and the condition of the neighboring cartilage. This article reviews the current updates in the treatment of osteochondral lesions of the talus to help clinicians use the available treatment strategies more efficiently.

Keywords: Talus, Cartilage, Joint, Chondrocyte, Therapeutics

Figures and Tables

Figure 1

Bone marrow stimulation to the osteochondral lesion of talus. (A) Identification of the lesion. (B) Debridement of frayed or fibrillated cartilage. (C) Microfracture on subchondral plate. (D) Release of marrow elements from exiting perforations.

Figure 2

Retrograde drilling for the treatment of subchondral cyst. (A) Computed tomography (CT) image of subchondral cyst. (B) Arthroscopic image of intact overlying cartilage. (C) Retrograde drilling under fluoroscopy. (D) CT image at 12-month follow-up.

Figure 3

Use of matrix in the autologous chondrocyte implantation. (A) Debridement of the lesion. (B) Application of CartiFill® (Sewon Cellontech, Seoul, Korea).

Figure 4

Autologous osteochondral transplacement to an osteochondral lesion of talus using the Osteochondral Autograft Transfer System® (Arthrex, Naples, FL, USA). (A) Identification of the lesion after medial malleolar osteotomy. (B) Debridement of damaged cartilage. (C) Harvest of autograft from the knee. (D) Insertion of autograft into the recipient hole in the talus.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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ORCID iDs: Hak Jun Kim
https://orcid.org/0000-0003-3633-6174
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