By Gian Luigi Canata, C. Niek van Dijk
This publication, released in cooperation with ISAKOS, is a concise, up to date consultant and reference at the therapy of cartilage lesions of the ankle that would be of functional medical price for experts in activities drugs and activities traumatology. varied options and the administration of varied lesions are defined step-by-step, guiding the practitioner in the course of the whole spectrum of care from review of the harm to winning restoration. Chondral and osteochondral lesions of the talus can current due to repetitive ankle accidents, inflicting power ache, recurrent swelling, and weak spot and stiffness of the ankle joint. a correct early analysis is needed, utilizing medical overview, imaging ideas and arthroscopy of the ankle. In acute and non-displaced chondral and osteochondral lesions, conservative therapy is the mainstay. surgical procedure is usually recommended for volatile and chronic lesions and is composed in numerous suggestions eager about regeneration of the cartilage. Returning to play is feasible after trying out stability and proprioception, energy, diversity of movement, and agility.
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Additional resources for Cartilage Lesions of the Ankle
Knee Surg Sports Traumatol Arthrosc 22(6):1311–1319. 1007/ s00167-013-2640-7 16. Battaglia M, Vannini F, Buda R et al (2011) Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: mid-term T2-mapping MRI evaluation. Knee Surg Sports Traumatol Arthrosc 19(8):1376–1384. 1007/s00167-011-1509-x 17. Giannini S, Buda R, Battaglia M et al (2013) One-step repair in talar osteochondral lesions: 4-year clinical results and t2-mapping capability in outcome prediction. Am J Sports Med 41(3):511–518.
Cartilage not supported by the subchondral bone changes, losing proteoglycans and glycoprotein, and water flows more freely into the evolving cyst. Remaining intact cartilage can act as a ball valve limiting egress of fluid out the bone when not weight bearing and compound the increasing hydrostatic pressure. Articular cartilage is aneural, but the underlying subchondral bone is maximally innervated by nocireceptors in the immediate subchondral bone. Macrophage-mediated local acidosis and intraosseous hypertension excite these receptors and lead to the typical deep ankle pain associated with cystic lesions.
J Bone Joint Surg Br 84(3):364–368 14. Baums MH, Schultz W, Kostuj T et al (2014) Cartilage repair techniques of the talus: an update. World J Orthop 5(3):171–179 15. Becher C, Thermann H (2005) Results of microfracture in the treatment of articular cartilage defects of the talus. Foot Ankle Int 26(8):583–589 16. Chen H, Sun J, Hoemann CD et al (2009) Drilling and microfracture lead to different bone structure and necrosis during bone-marrow stimulation for cartilage repair. J Orthop Res 27(11):1432–1438 17.