An Evidence-Based Update on Fixation Procedures for Acute and Chronic Osteochondral Lesions of the Talus

Cartilage, vol. 17, pp. 88–100

Abstract

Osteochondral lesions of the talus (OLT) involve the subchondral bone and the overlying articular cartilage. Various surgical treatments for these lesions are available, such as bone marrow stimulation (BMS), autologous osteochondral grafting, and fixation of an osteochondral fragment. Treatment choice depends on the condition of the lesion, which includes lesion size, morphology, location, and the presence of cysts. Among the surgical procedures available to date, in situ fixation of the osteochondral fragment has the advantage of restoring the articular surface while preserving the native hyaline cartilage and its subchondral bone. Fixation for OLT has been shown to be clinically successful for the treatment of both acute and chronic lesions. Moreover, the indication for osteochondral fragment fixation is expanding as recent studies have found good clinical outcomes in relatively small-sized lesions. The present article describes the current evidence on fixation for acute and chronic OLT.

Authors 10

1. Tomoyuki Nakasa corresponding

   Hiroshima University

   Affiliation as printed

   Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

2. Yasunari Ikuta

   Hiroshima University

   Affiliation as printed

   Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

3. Naoki Haraguchi

   Yokohama City Seibu Hospital

   Affiliation as printed

   Department of Orthopaedic Surgery, St. Marianna University Yokohama Seibu Hospital, Yokohama, Japan

4. Chul Hyun Park

   Yeungnam University

   Affiliation as printed

   Department of Orthopaedic Surgery, College of Medicine, Yeungnam University, Gyeongsan, Republic of Korea

5. Christian David Weber Aachen Department of Orthopaedic, Trauma, and Reconstructive Surgery

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Aachen, Germany

6. Quinten G.H. Rikken

   University of Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences

   Affiliation as printed

   Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

7. Jari Dahmen

   University of Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences

   Affiliation as printed

   Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

8. Sjoerd A.S. Stufkens

   University of Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences

   Affiliation as printed

   Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

9. Gino M. M. J. Kerkhoffs

   University of Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences

   Affiliation as printed

   Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

10. Masato Takao

    Kisarazu Hospital

    Affiliation as printed

    Clinical and Research Institute for Foot and Ankle Surgery, Jujo Hospital, Kisarazu, Japan