Arthroscopy: The Journal of Arthroscopic & Related Surgery
Case reportsOsteochondritis dissecans of the talus treated by the transplantation of tissue-engineered cartilage
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Case report
A 21-year-old female skier began to feel pain in her left ankle joint without any marked traumatic episodes. The pain gradually increased and she felt a catching sensation in the left ankle joint. She visited our clinic after several nonoperative treatments in another hospital over a period of 6 months had failed to reduce her symptoms. On physical examination, there was tenderness at the medial gutter of the ankle joint, although there was no swelling or deformity in her left ankle joint. The
Diagnostic arthroscopy and harvest of cartilage pieces
Arthroscopic examination of the ankle joint revealed that she had a detaching unstable large osteochondral fragment at the medial talar dome (Fig 3). The size of the lesion was 10 mm in length and 15 mm in width. The cartilage of the fragment was severely fibrillated and could not be returned to its original place with normal congruity of the surface. We decided to perform a transplantation of tissue-engineered cartilage and harvested the cartilage pieces from the unloaded area of the medial
Discussion
Although the prevalence of osteochondral lesions such as osteochondritis dissecans or traumatic osteochondral injury of the talus had been previously underestimated, recent progress and the widespread introduction of arthroscopy to ankle surgery have revealed a higher prevalence of osteochondral lesions of the talus.16, 17 Osteochondral lesions of the talus have been problematic, causing prolonged pain and considerable disruption of daily and sports activities. Management of osteochondral
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Cited by (24)
Synthesis, characterization and in vitro biological properties of simultaneous co-substituted Ti+4/Li+1 58s bioactive glass
2021, Journal of Non-Crystalline SolidsCitation Excerpt :Bone is one of the connective tissues, which due to its very complex and dynamic structure, can regenerate different types of cells such as osteoblasts, osteoclasts, and osteocytes through combined function [1]. Millions of people have been suffering from tissue deficiencies or organ failures such as cartilage osteochondritis dissecans, bone graft as well as bone internal fixation [2–4]. Several researchers have defined tissue engineering (TE) as an interdisciplinary field that introduces engineering, clinical medicine, and science to develop biological alternatives that enhance the recovery, preservation, or improvement of tissue function [2,5].
Trends in Ankle Arthroscopy and Its Use in the Management of Pathologic Conditions of the Lateral Ankle in the United States: A National Database Study
2015, Arthroscopy - Journal of Arthroscopic and Related SurgeryTopographic variations in biomechanical and biochemical properties in the ankle joint: An in vitro bovine study evaluating native and engineered cartilage
2014, Arthroscopy - Journal of Arthroscopic and Related SurgeryScaffolds for cartilage repair of the ankle joint: The impact on surgical practice
2013, Foot and Ankle SurgeryCitation Excerpt :At 5 years of mean follow-up a good clinical outcome was confirmed, with the most satisfactory results observed in patients with the longest follow-up and in case of lesions with depth <3 mm, and this new non-invasive imaging method showed 69% of the lesion area filled with a regenerated tissue compatible with normal hyaline cartilage. A case report by Agung et al. [57] described another second generation autologous chondrocyte transplantation, which involved the implant of an Atelocollagen cell-loaded scaffold in a patient with an unstable large osteochondral fragment at the medial talar dome. Two years after surgery the lesion was filled with smooth cartilaginous tissue and the patient was pain-free and with full recovery of joint range of motion.
Osteochondral transfer using a transmalleolar approach for arthroscopic management of talus posteromedial lesions
2009, Orthopaedics and Traumatology: Surgery and Research