By Gian Luigi Canata, C. Niek van Dijk
This publication, released in cooperation with ISAKOS, is a concise, updated consultant and reference at the remedy of cartilage lesions of the ankle that may be of sensible scientific price for experts in activities medication and activities traumatology. diverse thoughts and the administration of varied lesions are defined step-by-step, guiding the practitioner in the course of the whole spectrum of care from overview of the harm to profitable restoration. Chondral and osteochondral lesions of the talus can current on account of repetitive ankle accidents, inflicting continual ache, recurrent swelling, and weak spot and stiffness of the ankle joint. a correct early prognosis is needed, utilizing medical evaluate, imaging strategies and arthroscopy of the ankle. In acute and non-displaced chondral and osteochondral lesions, conservative remedy is the mainstay. surgical procedure is usually recommended for risky and chronic lesions and is composed in numerous options occupied with regeneration of the cartilage. Returning to play is feasible after checking out stability and proprioception, energy, diversity of movement, and agility.
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5). Under the influence of cytokines and growth factors, they differentiate into chondrocyte type cells and produce fibrocartilage containing predominantly type I collagen. Cystic lesions require curettage and penetration of the calcified wall of the cyst. 5 cm2) [16, 22]. The procedure has a low morbidity and complication rate and low cost and is technically undemanding. Gobbi et al. performed a randomised study of 30 patients comparing chondroplasty with microfracture and autologous osteochondral transplantation .
1 Talar osteochondral lesion with cystic degeneration Fig. 2 MRI 2 months later. L. Canata and V. Casale 4 Arthroscopic Debridement of Osteochondral Lesions of the Talus 31 The technique is supplemented by excision and curettage of the damaged tissue for better results . It is well documented that arthroscopic excision, curettage and bone marrow stimulation should be the first treatment of choice for primary osteochondral talar lesions: this procedure is relatively inexpensive; there is low morbidity, a quick recovery and a high success rate .
10 Final levels of the grafts with good congruency At the end of the procedure, the tourniquet is released, bleeding is controlled and a well-padded compression dressing is applied. The patient is observed for 24 h to administer iv antibiotics and control pain, and the operated extremity should be elevated. Knee drain is removed after 24 h. Promotion of active range of motion and progressive weight-bearing are the most important postoperative goals. 10 Rehabilitation Non-weight-bearing for 3 weeks and partial loading with 30 kg for 3 weeks are the standard protocol during rehabilitation.
Cartilage Lesions of the Ankle by Gian Luigi Canata, C. Niek van Dijk