Osteochondritis Dissecans TaliA Review and Case Presentation

Seregelyi T.Dr. Solyom A.Dr. Ivanescu A.Prof. Dr. Bataga T.

Osteochondritis Dissecans Tali

“os-tee-o-kon-DRY-tis DIS-uh-kanz”

Osteo = Bone,Chondros = Cartilage, Dissecare = to Dissect, reject

What is Osteochondritis Dissecans ?

“Dissecating Osteochondral Lesion Of The Talus” (Assenmacher et al)

or

“Transchondral Talar Dome Fracture” (Kocher et

al) ?

Etiology ?

External

• Antero-Lateral Talar Dome Lesion

• History of Trauma (sprain or strain)

• Wafer-shaped

• More Aggressive (/surgical) Treatment recommended

Internal

• Medial Talar Dome

• Associated with Chronic Overload (eg. cavus foot)

• Cup-shaped

• More Frequent• Often Asymptomatic

Signs & Symptoms

-> Unspecific

Gradual onset of Chr. Activity-Related PainIntermittent EdemaDecreased ROMJoint lockingInstabilityPopping soundsLimping

Diagnosis

Anamnesis Xray CT (sections) Scintigraphy (for screening) MRI (gold standard, classification) +/- Arthroscopy (in discussion now)

Classification

Ferkel Loomer CT

Berndt & Harty

Berndt & Harty

stage 1 Stage 2

Berndt & Harty

Stage 3 Stage 4

Case Presentation

Tx: Mosaicplasty

ipsilateral mosaicplasty-type autologous osteochondral grafting

Intra-operative fluoroscopic view showing the two 4.5mm cannulated screw fixation of medial malleolus after graft implantation

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