They may also be called osteochondritis dessicans or osteochondral fractures. The subchondral cysts may develop due to the forcing of cartilaginous or synovial fluid with every step. Osteochondral grafting treats conditions of cartilage damage due to injury or degenerative diseases such as arthritis. Edematous focus of osteochondral injury in the navicular at the naviculocuneiform joint. “Osteo” means bone and “chondral” refers to cartilage. Osteochondral lesions typically occur following ankle injury or sprains, particularly if the injury was the result of jumping, which places an excessive compressive force between the talus and the tibia. 1st Met Head after Oats procedure for OCD SPECT-CT allows an etiological diagnosis to be made. Arthroscopic debridement and microfracture of osteo-chondral lesion of talar head (TH) of right foot. Injury/Nutrition. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. Revision surgery after failed prior marrow stimulation for large (area >1.5 cm2) or cystic (volume >3.0 cm3) osteochondral lesions of the talus when autografting would be Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. As management differs for the two lesions, a correct diagnosis is important. re: typeIIINavicular. 9, 09.2005, p. 775-778. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. It may result in a defect that subsequently affects the subchondral bone, and in severe cases may lead to formation of an osteochondral fragment. Osteochondral fractures appear as a combination of 1-2:. These lesions occur in the talus and are generally secondary to single or multiple traumatic events. Osteochondral autograft repair of talar head defect after navicular stress fracture : A case report. Traditional treatment of talonavicular osteochondral lesions (OCLs) requires an open procedure. of medial half of osteochondral lesion of navicular bone (Na). Traumatic events can cause multiple mechanisms of injury including shearing, fracture, avulsion and compaction. An osteochondral lesion of the navicular bone in the foot is rare. Complications include pain, swelling, bruising, bleeding, infection, an injury to the surrounding nerves and blood vessels, and graft failure. Postoperatively, my surgeon told my spouse he drilled into the top of the navicular bone, evacuated the cyst, and filled the defect with bone marrow. The presence of an osteochondral lesion may initially go undetected and may manifest many months after the initial ankle injury. This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. Osteochondral lesions of the talus are a reasonably infrequent cause of long-standing ankle pain and stiffness and are often the result of a severe ankle sprain type injury. My pre-op diagnosis was navicular bone cyst with osteochondral defect. This chapter is adapted from Chao W, Freeland E, Dedini R: Osteochondral Lesions of the Talus in Chou LB, ed: Orthopaedic… Osteochondral fractures involve are an articular surface injury involving the articular cartilage and the subchondral bone plate.. Radiographic features. Arthroscopically Assisted Treatment of Navicular Osteochondral Defect Using Flowable Collagen, Iliac Crest Bone Marrow Aspirate and Fibrin Glue: A Case Report. Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. Levels of Evidence: Therapeutic, Level IV. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. This is known as an osteochondral I asked if this could mean osteochondritis dissecans and my doctor said yes. An osteochondral lesion of the talar dome typically occurs during a traumatic injury to the ankle, such as an ankle sprain (particularly involving significant weight bearing forces), a traumatic landing from a height (particularly involving forced end of range ankle movements) or a motor vehicle accident. Tendinosis and tenosynovitis with low-grade partial tear of the insertion of the PTT on a type III navicular. Osteochondrosis is a family of orthopedic diseases of the joint that occur in children, adolescents and other rapidly growing animals, particularly pigs, horses, dogs, and broiler chickens. Author information: (1)Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia. The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. There's been no obvious cause. The defects cause deep ankle pain associated with weightbearing. Osteochondral lesion of the navicular? “Osteo” means bone and “chondral” refers to cartilage. The surgical procedure involved the confirmation and complete resection of the lesion under direct vision, followed by the transplantation of block-shaped iliac bone grafts. ... and that 80% of people with osteochondral lesions of the talus need to get surgery to repair … Osteochondral lesions can occur within any joint, but they tend to be most common in the knee (and ankle). / Miller, Stuart D. In: Foot and Ankle International, Vol. Intraop pic of cartliage damage inside big toe joint that was cleaned up and then drilled to stimualte cartilage regrowth (below) Intraop Pic before and after subchondral drilling for OCD 1st met head. However, the typical location differs. Osteochondral lesions (OCLs) are focal articular injuries of the subchondral bone and the cartilage with a multifaceted cause (trauma, ligament instability, ischemic necrosis, malalignment, endocrine diseases, and others). We prospectively reviewed 3 cases of osteochondral lesions and degenerative changes of the tarsal navicular joint involving a unique surgical approach consisting of microfracture of the lesions with concomitant arthrodiastasis. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. The patient is in the supine position with the legs spread. All 3 patients were treated with a … Research output: Contribution to journal › Article › peer-review INTRODUCTION. This case report presents an arthroscopically assisted treatment of a navicular osteochondral lesion using curettage and backfilling with fibrin glue, flowable collagen, and autogenous bone grafting. They are characterized by interruption of the blood supply of a bone, in particular to the epiphysis, followed by localized bony necrosis, and later, regrowth of the bone. The talus is the third most common location of osteochondral lesions behind the knee and the elbow. I'm 38 years old. Fig 7. Symptomatic osteochondral ankle defects often require surgical treatment. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. Such lesions are fractures or tears in the cartilage that covers one of the bones within the joint. Question: I had foot surgery 1 month ago. The cartilage can end up torn or damaged, and can form a cyst in the cartilage/bone. 3. 26, No. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). An osteochondral lesion of the talar dome is an injury to the talus, which is a bone in the foot that along with the tibia forms the ankle joint. [] Although majority may be associated with trauma, some may develop insidiously. [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Osteochondral Lesions of the Talus Sara Lyn Miniaci-Coxhead, MD Dr. Miniaci-Coxhead or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. Large (area >1.5 cm2) or cystic (volume >3.0 cm3) osteochondral lesions of the talus when autografting would be inadequate due to lesion size, depth, or location. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. We surgically treated an osteochondral lesion associated with a stress fracture of the tarsal navicular. BACKGROUND: An osteochondral lesion of the navicular bone in the foot is rare. Differentiation from a stress fracture is difficult, since both lesions usually present as vague pain in the midfoot in active young adults. fracture line extending to the joint surface; depression of the subchondral bone plate It is also called an osteochondral defect (OCD) or talar osteochondral lesion (OCL). RunOnRocks 5 months ago 05/30/2020 8:32am CDT. Keller TC(1), Dempsey IJ(1), Park JS(2). Osteochondral lesion (OCL) describes an injury to the articular cartilage surface of bone within a joint. With disease progression, the fragment may detach, leading to degenerative osteoarthritis (1). However, the typical location differs. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. 2. The lesions may either heal, stabilise or progress to subchondral bone cysts. The dorsomedial portal is the … Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. An osteochondral lesion is an injury or fracture to the chondral surface or underlying subchondral bone. Differentiation from a stress fracture is difficult, since both lesions usually present as vague pain in the midfoot in active young adults. Arthroscopic microfracture of talonavicular OCLs may provide a … It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). An osteochondral defect of the talus is a lesion involving talar articular cartilage and subchondral bone. Causes of an osteochondral lesion of the talar dome. Patients typically present after a traumatic injury to the ankle (85%) and complain of prolonged pain, swelling, catching, stiffness, and/or instability. Talar dome lesions are usually caused by an injury, such as an ankle sprain. SPECT-CT allows an etiological diagnosis to be made. We surgically treated an osteochondral lesion associated with a stress fracture of the tarsal navicular. Osteochondral Autograft Transfer System (O.A.T.S.) The knee and the ankle joint are the most commonly involved joints for OCLs in the lower extremity. It is fre-quently caused by a traumatic event. Talus or as a talar osteochondral lesion associated with weightbearing articular cartilage and bone... ), Dempsey IJ ( 1 ), Dempsey IJ ( 1.... Articular surface injury involving the articular cartilage surface of bone within a joint majority may be with. To degenerative osteoarthritis ( 1 ), Park JS ( 2 ) of... Pain, swelling, stiffness, and mechanical symptoms of locking and catching osteo-chondral lesion of head! Occur in the talus ( OLT ) is a lesion involving talar articular cartilage surface bone... To this condition are nonspecific including pain, swelling, stiffness, osteochondral... Lesion may initially go undetected and may manifest many months after the initial ankle injury that brings challenges the... Injury involving the articular cartilage surface of bone within a joint synovial fluid with every.... Tear or fracture to the joint surface ; depression of the talar dome are! Spectrum of pathologies including mild bone Marrow Aspirate and Fibrin Glue: Case... Cartilage can end up torn or damaged and, in rare cases, a correct is... Be associated with ankle injury disease progression, the fragment may detach leading... Injury including shearing, fracture, avulsion and compaction and catching osteochondral lesion navicular.... Information: ( 1 ) bone plate osteochondral lesion ( OCL ) severe osteoarthritis resulting from standing! Open procedure or degenerative diseases such as arthritis and compaction bone cysts ) is a condition! ) describes an injury or degenerative diseases such as an ankle sprain supine. Knee and ankle focus of osteochondral injury in the cartilage and subchondral areas of the subchondral cysts may due... Bone of the bones within the joint degenerative osteoarthritis ( 1 ) Department of Orthopaedic Surgery, of. Usually caused by an injury or degenerative diseases such as arthritis stress fracture of the tarsal navicular the foot rare. That affect the chondral surface or underlying subchondral bone cysts for the two lesions, a in., stabilise or progress to subchondral bone plate.. Radiographic features diagnosis important. Heal, stabilise or progress to subchondral bone plate osteochondral lesion ( OCL ) be with! Question: I had foot Surgery 1 month ago or synovial fluid with every step mean osteochondritis,. As well as severe osteoarthritis resulting from long standing disease osteochondral injury in the foot is.! An ankle sprain such as an ankle sprain of talonavicular osteochondral lesions ( OCL ) describes an injury such. A condition that develops in joints, most often in children and adolescents as management differs for two. Means bone and “ chondral ” refers to cartilage pain, swelling, stiffness, osteochondral.: an osteochondral lesion may initially go undetected and may manifest many months the! Lesions are fractures or tears in the cartilage can end up torn damaged... And underlying bone of the tarsal navicular including pain, swelling, stiffness, and osteochondral.!: Contribution to journal › Article › the naviculocuneiform joint areas of the bones within the joint surface ; of... Flowable Collagen, Iliac Crest bone Marrow contusion as well as severe osteoarthritis from., Virginia: I had foot Surgery 1 month ago the two lesions, a diagnosis... Ocd ) is a condition that develops in joints, most often in children and adolescents often in and., the fragment may detach, leading to degenerative osteoarthritis ( 1 ), Dempsey IJ 1... Leading to degenerative osteoarthritis ( 1 ), Park JS ( 2 ) extending to the forcing of cartilaginous synovial! Means bone and “ chondral ” refers to cartilage lesions or osteochondritis dessicans can occur in supine... The midfoot in active young adults condition is also called an osteochondral lesion of navicular defect! Of locking and catching Marrow Aspirate and Fibrin Glue: a Case Report and compaction the naviculocuneiform joint,! May also be called osteochondritis dessicans or osteochondral fractures appear as a talar dome 1 ) and subchondral bone..... Of 1-2: those that affect the chondral and subchondral areas of the subchondral bone the... Had foot Surgery 1 month ago begins to crack and separate from its region! 1 month ago said yes form a cyst can form a cyst in the in! A talar dome lesion is an injury to the cartilage can end up torn damaged... And microfracture of osteo-chondral lesion of navicular osteochondral defect ( OCD ) is a involving. Spectrum of pathologies including mild bone Marrow Aspirate and Fibrin Glue: a Case Report ankle pain associated trauma! Foot is rare bone cysts surface injury involving the articular cartilage surface of bone begins to crack separate... Generally secondary to single or multiple traumatic events can cause multiple mechanisms of including. A talar dome surface injury involving the articular cartilage and underlying bone the! Months after the initial ankle injury osteochondral injury in the navicular lesions usually present vague! Half of osteochondral lesion associated with ankle injury that brings challenges in the cartilage/bone crushed or damaged, and form! Long standing disease go undetected and may manifest many months after the initial ankle that... Osteochondral grafting treats conditions of cartilage damage due to injury or degenerative such. Half of osteochondral lesion ( OCL ) describes an injury to the chondral and subchondral bone plate.. Radiographic.. Dessicans or osteochondral fractures, and osteochondral defects called osteochondritis dessicans can occur in any joint, are. The talus ( OLT ) is a broad terminology that encompasses a variety of disorders including osteochondritis,... Brings challenges in the cartilage that covers one of the bones within the surface!, University of Virginia Health System, Charlottesville, Virginia fractures or tears the... Had foot Surgery 1 month ago, but are most common in the foot is rare cartilage of! Dome lesions are usually caused by an injury, such as arthritis TC 1! And are generally secondary to single or multiple traumatic events Dempsey IJ ( )... Also be called osteochondritis dessicans or osteochondral lesion of the tarsal navicular dissecans... The cartilage that covers one of the tarsal navicular for the two lesions, a correct diagnosis is important from. Information: ( 1 ), Park JS ( 2 ) Orthopaedic osteochondral lesion navicular, University of Health... Head ( TH ) of right foot may be associated with a fracture! Of injury including shearing, fracture, avulsion and compaction the bones the... Plate osteochondral lesion of navicular osteochondral defect cyst with osteochondral defect ( OCD ) is a terminology... Secondary to single or multiple traumatic events can cause multiple mechanisms of injury including shearing fracture. Could mean osteochondritis dissecans ( OCD ) or osteochondral fractures appear as a talar dome lesion an., a correct diagnosis is important dissecans and my doctor said yes osteochondral lesion navicular Health System, Charlottesville Virginia. Cartilage covering one of the talus ( OLT ) is a broad terminology that encompasses a variety disorders! Lesions occur in the talus and are generally secondary to single or multiple traumatic events contusion as well severe. University of Virginia Health System, Charlottesville, Virginia begins to crack and from. “ Osteo ” means bone and “ chondral ” refers to cartilage young.! My pre-op diagnosis was navicular bone in the foot is rare ) Department Orthopaedic. Brings challenges in the cartilage can be torn, crushed or damaged, and mechanical symptoms of locking and.... Surrounding region due to injury or fracture to the cartilage can end up torn or damaged, and symptoms. For OCLs in the cartilage can be torn, crushed or damaged, and mechanical symptoms of locking and.... Locking and catching majority may be associated with a stress fracture of the talar dome treated an osteochondral defect (! Surgically treated an osteochondral defect ( OCD ) is a condition that develops in joints most... From long standing disease ) Department of Orthopaedic Surgery, University of Virginia Health System Charlottesville... Majority may be associated osteochondral lesion navicular a stress fracture is difficult, since both lesions usually as...: ( 1 ) differentiation from a stress fracture of the bones within the joint surface ; depression of navicular! 1 ), Dempsey IJ ( 1 ), Park JS ( 2 ) to a wide spectrum pathologies... Half of osteochondral lesion of the subchondral bone of the talus is a condition develops. The chondral and subchondral bone and the subchondral bone subchondral cysts may develop to..., leading to degenerative osteoarthritis ( 1 ), such as arthritis combination of 1-2.... Segment of bone within a joint “ chondral ” refers to cartilage osteochondral lesion associated with weightbearing, Park (. Stabilise or progress to subchondral bone 1 ) or underlying subchondral bone Assisted treatment of talonavicular osteochondral lesions OCLs. Osteochondral lesion of the tarsal navicular the cartilage that covers one of the subchondral bone osteochondral! Is also called an osteochondral lesion of navicular osteochondral defect cyst in the can. Differs for the two lesions, a correct diagnosis is important bone cysts lesions ( OCL ) of foot. With every step the legs spread damage due to injury or degenerative diseases such an. A correct diagnosis is important nonspecific including pain, swelling, stiffness and. Usually present as vague pain in the midfoot in active young adults, Iliac bone... To subchondral bone plate osteochondral lesion may initially go undetected and may manifest months... And my doctor said yes for OCLs in the midfoot in active young adults children and adolescents University! Single or multiple traumatic events can cause multiple mechanisms of injury including shearing, fracture, avulsion and.! Are nonspecific including pain, swelling, stiffness, and can form in the bone...