Skip to main content
Erschienen in: Operative Orthopädie und Traumatologie 2/2023

Open Access 09.01.2023 | Surgical Techniques

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for lateral osteochondral lesions of the talus: operative technique

verfasst von: Jari Dahmen, MD, BSc, Quinten G. H. Rikken, BSc, Gino M. M. J. Kerkhoffs, MD, PhD, Sjoerd A. S. Stufkens, MD, PhD

Erschienen in: Operative Orthopädie und Traumatologie | Ausgabe 2/2023

Abstract

Objective

To provide a natural scaffold, good quality cells, and growth factors to facilitate replacement of the complete osteochondral unit with matching talar curvature for large osteochondral lesions of the lateral talar dome.

Indications

Symptomatic primary and non-primary lateral osteochondral lesions of the talus not responding to conservative treatment. The anterior–posterior or medial–lateral diameter should exceed 10 mm on computed tomography (CT) for primary lesions; for secondary lesions, there are no size limitations.

Contraindications

Tibiotalar osteoarthritis grade III, malignancy, active infectious ankle joint pathology, and hemophilic or other diffuse arthropathy.

Surgical technique

Anterolateral arthrotomy is performed after which the Anterior TaloFibular Ligament (ATFL) is disinserted from the fibula. Additional exposure is achieved by placing a Hintermann distractor subluxating the talus ventrally. Thereafter, the osteochondral lesion is excised in toto from the talar dome. The recipient site is micro-drilled in order to disrupt subchondral bone vessels. Thereafter, the autograft is harvested from the ipsilateral iliac crest with an oscillating saw, after which the graft is adjusted to an exactly fitting shape to match the extracted lateral osteochondral defect and the talar morphology as well as curvature. The graft is implanted with a press-fit technique after which the ATFL is re-inserted followed by potential augmentation with an InternalBrace™ (Arthrex, Naples, FL, USA).

Postoperative management

Non-weightbearing cast for 6 weeks, followed by another 6 weeks with a walking boot. After 12 weeks, a computed tomography (CT) scan is performed to assess consolidation of the inserted autograft. The patient is referred to a physiotherapist.
Hinweise

Herausgeber

H. Waizy, Hannover

Zeichner

H. Konopatzki, Heidelberg
Scan QR code & read article online

Introductory remarks

An osteochondral lesion of the talus (OLTs) is characterized by damage to the talar articular cartilage and the underlying subchondral bone. These lesions are predominantly caused by ankle fractures or ankle sprains, but can also have an idiopathic or genetic origin [11, 33]. This is evidenced by recent literature from which we know that 45% of acute ankle fractures are associated with concomitant damage to the (osteo)chondral unit of the ankle, with the talar bone being the most frequently reported location [22].
Currently, there is no superior treatment for primary or secondary OLTs [9, 18]. However, it is recommended to initiate treatment of patients with painful OLT with an appropriate conservative treatment protocol in the context of individualized care. This treatment protocol can consist of supervised neglect, a period of immobilization, (multiple) injections of hyaluronic acid, supervised physiotherapy, and specific prescription of insoles [9, 34, 42]. However, the majority of patients will remain symptomatic and progress to a surgical strategy. The choice of the specific surgical intervention in question largely depends on specific lesion factors, such as the primary or non-primary nature of the lesion, lesion dimensions, and lesion morphology [31].
For small primary defects, first-line surgical management may consist of (arthroscopic) bone marrow stimulation or retrograde drilling [7, 9, 18]. For lesions that are amenable to fixation (fragmentous lesions), arthroscopic and open internal fixation procedures have been proven to be effective [15, 16, 19, 29, 30]. In the case of relatively large (cystic) lesions of the talar dome or in the case of lesions that have failed prior surgical intervention(s), it is probable that more invasive surgical interventions will be necessary in order to adequately address the patients’ complaints [18]. These surgical interventions may consist of transplantation techniques such as (osteo)chondral transplantation, including the classical osteochondral autograft transfer system (OATS) and chondrocyte implantation techniques [38]. Alternatively, one can consider bulk allografting—a surgical technique used whenever the lesion can be considered “massive” and a surgeon expects that insufficient autografting material will be obtained. The aforementioned techniques show adequate clinical efficacy in terms of clinical success rates, as previously assessed by Dahmen et al. [9] and Lambers et al. [18]. However, it can be stated that each of the surgical techniques for larger and/or cystic OLTs are associated with specific downsides. For example, it has been proven that the OATS procedure can cause a donor-site morbidity incidence rate ranging from 11% to 35% when the graft is harvested from the ipsilateral femoral condyle [9, 12]. A different example of a specific downside can be nonunion, whereas for the cartilage implantation techniques, the financial investment can be regarded as a downside [1].
A potential alternative to the aforementioned techniques may be harvesting of autologous osteoperiosteal grafts. Cylindrical use of osteoperiosteal grafts has previously been documented by Hu et al. [12] and Chen et al. [6], and yielded clinically effective outcomes. It is, however, a common downside of cylindrical grafts that the size of the cylindrical autograft is static and determined preoperatively [39].
In order to overcome the aforementioned downsides, a novel technique for the treatment of large talar osteochondral lesions has recently been developed and was previously described in the present journal for medially located lesions [14]. The Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) procedure uses the ipsilateral iliac crest with the overlying periosteal layer as the harvesting location for the autograft. The periosteal layer has the potential to induce articular cartilage-like tissue regeneration as the cambium layer of the periosteum contains chondrocyte precursor cells [13, 23, 26]. The TOPIC bone–periosteal transplant meets the three requirements for tissue engineering for bone and cartilage repair: a source of cells, a scaffold, and local growth factors [3, 21, 32, 36]. In addition, the curvature of the iliac crest is highly similar to the curvature of the talar bone, and the harvested graft can be exactly fitted to the excised OLT, leading to a press-fit graft [25].
However, the previously published description of the TOPIC technique was limited to medially located osteochondral lesions of the talus. We know from a recent publication by van Diepen et al. [40] that 24% of the lesions that are located on the talar bone are specifically located on the lateral talar dome. The previous description focusing on medially located lesions can be considered substantially different to lateral lesions, as for the medially located lesions, a distal tibial osteotomy is considered a necessary first step in the procedure through which appropriate visualization is created. Laterally located lesions can be approached without the use of distal tibial osteotomies, though require different steps for approaching the lesion. This substantiates the necessity of a detailed presentation of the surgical technique of the lateral TOPIC procedure consisting of a specific stepwise approach.
The purpose of the current study is therefore to describe the surgical technique of the newly developed lateral TOPIC procedure, to evaluate potential pearls and pitfalls, and to present the first clinical outcomes of patients who have undergone the lateral TOPIC procedure.

Surgical principle and objective

Large symptomatic osteochondral lesions to the talus of primary or non-primary nature are challenging. Currently, there are many surgical techniques available for this indication, with their individual advantages and disadvantages. Over the past decades, surgical and scientific attention has been focused on medially located lesions of the talar dome. However, as we are aware of the fact that 24% of the OLTs are located on the lateral talar dome and that the laterally located OLTs are associated with chronic lateral ankle instability, there is a clinical need to present surgical techniques that are amenable and effective for laterally located OLTs [2, 37, 40, 41, 43]. Moreover, it is stated that concomitant lateral ankle instability is considered a negative prognostic factor regarding the clinical outcomes of surgical treatment of OLTs [17, 20, 27]. Consequently, this highlights the clinical relevance and importance of addressing laterally located lesions appropriately in the case of lesions of large (cystic) nature and in case of concomitant (chronic) lateral ankle instability. A novel innovative surgical technique for the surgical treatment of large OLTs has recently been developed and was previously described in the present journal. However, this technique focused exclusively on medially located OLTs, not on laterally located OLTs with possible concomitant (chronic) lateral ankle instability [14]. The present surgical technique paper therefore describes the surgical technique of treatment of large (cystic) primary and secondary lateral osteochondral lesions of the talus. The technique comprises (antero)lateral arthrotomy, press-fit talar autograft transplantation from the ipsilateral iliac crest, and lateral ankle ligament reconstruction potentially augmented with an InternalBrace™ (Arthrex, Naples, FL, USA). The technique provides a natural scaffold, good quality cells, and growth factors, facilitating replacement of the complete osteochondral unit—a triad considered to be of vital importance in the treatment of these defects. Moreover, the technique can directly and simultaneously address (chronic) lateral ankle instability, which is a common concomitant diagnosis in painful osteochondral lesions of the talus [2, 37, 40, 41, 43].

Advantages

  • Concomitant lateral ankle ligament repair/reconstruction (with potential augmentation by InternalBrace™) in the case of (chronic) lateral ankle instability (instead of ligament reconstruction)
  • Similar surface geometry and curvature of the talar dome compared to the iliac crest [25].
  • Iliac crest graft provides scaffold, cells, and growth factors [3, 21, 32, 36].
  • No need for an osteotomy due to the location of the defect (whenever the lesion is located on the anterior 80% of the lateral talar dome; if the lesion is located on the posterior 20% of the lateral talar dome, a fibular osteotomy can be considered).
  • Cost effective.
  • Single-stage technique.
  • Limited operation time.

Disadvantages

  • Complications specifically for the harvest site, the iliac crest, and hyp(er)aesthesia skin [10].
  • Potential complications of the superficial peroneal nerve due to the surgical approach.
  • Secondary osteoarthritis.

Indications

  • Symptomatic large (cystic) laterally located osteochondral lesion of the talar dome with deep ankle pain not responding to conservative treatment with or without the presence of (chronic) lateral ankle instability;
    • anterior-posterior or medial-lateral lesion diameter should exceed 10 mm on computed tomography (CT),
    • the depth of the defect is no limitation for this procedure.
  • Both primary and secondary lesions are eligible for treatment with TOPIC
  • In case of malalignment, a corrective osteotomy can be considered.

Contraindications

  • Tibiotalar osteoarthritis grade III (Kellgren and Lawrence).
  • Malignancy.
  • Active infectious ankle joint pathology.
  • Hemophilic or other diffuse arthropathy.

Patient information

  • Surgical risks include infection, hematoma, thromboembolic event, wound healing problems.
  • Transient or permanent nerve damage leading to hyper/o aesthesia of the superficial peroneal nerve.
  • Non-weightbearing cast for 6 weeks, followed by a walking boot for another 6 weeks.

Preoperative workup

At the Department of Orthopedic Surgery and Sports Medicine of the Amsterdam University Medical Centers (AUMC) we have a standardized workup for all patients: patients are carefully screened for patient history (including recurring ankle sprains and/or a feeling of giving way of the ankle) and undergo a thorough physical examination of both lower extremities and ankles, during which specific attention is paid to recognizable pain on palpation over the site of the osteochondral lesion(s) with the ankle in plantar flexion [31]. Special emphasis is also put on the range of motion of the ankle joint, especially plantar flexion [8]. Moreover, a highly important part of the physical examination is to carefully assess whether there is also presence of (chronic) lateral ankle instability of symptomatic nature.
For confirmation of the diagnosis and as a preoperative sizing and planning tool, an additional dual-energy computed tomography scan (CT) is made. At our center, experienced fellowship-trained musculoskeletal radiologists and the orthopedic surgeons assess all OLTs for lesion size, morphology, shaping, and curvature. Lesion size is assessed three-dimensionally, taking into account the morphology of the lesion in a simultaneous fashion in order to yield a three-dimensional visualization and representation of the lesion allowing for a personalized approach [31]. The three-dimensional analysis concerns measuring the sclerotic borders of the lesion. This is performed by measuring the lesion from the most anterior point to the most posterior point (AP direction), as well as from the most medial point to the most lateral point (ML direction), and finally, the depth is measured by measuring the distance from the joint line to the most distal part of a cyst most often including the caudal sclerotic zone of the cyst, as this will be removed accordingly. After careful shared decision-making process together with the patient and their family, the patient and the treating team will decide for the lateral TOPIC procedure together.

Instruments and implants

  • Coagulation knife
  • Hohmann retractors
  • Oscillating saw and/or chisel with thin blades
  • Beaver knife
  • Hemostatic gelatin sponge (Spongostan®; Ethicon, Somerville, NJ, USA)
  • Impactor
  • Standard orthopedic set
  • Chisel set
  • Hintermann distractor
  • Ligament bracing equipment (InternalBrace™)

Anesthesia and positioning

  • General or spinal anesthesia
  • Antibiotic prophylaxis (Cefazolin 2 g intravenous injection) is administered to each patient
  • Supine position with a tourniquet applied around the thigh

Surgical technique

(Figs. 1234567)

Special surgical considerations

  • A preoperative dual-energy CT scan allows for optimal radiological assessment of lesion morphology and lesion size. This method yields a 3D visualization and representation of the lesion, allowing for a personalized approach both preoperatively as well as intraoperatively [31].
  • A concomitant lateral ankle ligament repair/reconstruction with the potential augmentation with an InternalBrace™ is clinically relevant and surgically located in an optimal position due to the (antero)lateral approach, allowing for prognostically positive outcomes [17, 20, 27].
  • The iliac crest autograft transplantation is adjusted for and customized for each individual patient.
  • Press-fit autograft transplantation allows for a one-stage procedure and quick rehabilitation, without the clinical necessity of intra-articular screw removal.
  • An optimal (osteoperiosteal) graft to replace an osteochondral unit has the following characteristics: natural scaffold, good quality cells, and growth factors [28, 35].

Postoperative management

Postoperatively a lower leg splint is provided for the first 24 h, after which a fresh circular non-weightbearing lower leg cast is applied for 2 weeks. 2 weeks postoperatively, the stitches are removed and the patient is motivated and allowed to perform dorsoplantar motion of the ankle so that postoperative deficits in range of motion in the dorsoplantar direction can be addressed. Moreover, these movements may simulate the progenitor cells from the periosteum to produce an optimal chondral layer following stimulation through ankle joint motion [4, 5].
The non-weightbearing period is 6 weeks and at the 6‑week follow-up, a walking boot is applied for another 6 weeks, allowing the patient (gradual) weightbearing as tolerated. At 12 weeks postoperatively, a dual-energy CT scan is performed in order to assess consolidation of the inserted iliac crest autograft. At this particular outpatient visit, a personalized physiotherapeutic plan is provided to the patient and the physiotherapist in order to allow for evidence-based individualized build-up of activities, with gradual and protocol-based return to sport and work. In order to monitor progress, the patient is clinically assessed at 6 months and 1 and 2 years postoperatively. The patient is advised to not perform any axial-loading peak forces for at least 6 months postoperatively.

Errors, hazards, and complications

At every follow-up, patients are checked for potential complications, such as crest pain, hyp(er)aesthesia in the crest and ankle joint region, infections, ankle joint synovitis, and postoperative pain. A CT scan will be made at 3, 12, and 24 months after surgery to assess consolidation, talar remodeling, and ingrowth of the transplant (Fig. 8). Potential pitfalls:
  • In case of inadequate restoration of lateral ankle biomechanics by means of lateral ankle ligament repair/reconstruction with potential augmentation with an InternalBrace™, persistent (symptomatic) lateral ankle instability may occur.
  • Avulsion or fracture of the iliac crest when harvesting the graft too close to the anterior superior iliac spine.
  • Proudness of the autograft might result in chondral wear or a kissing lesion to the opposing distal anterolateral corner of the ankle joint (fibula/distal tibia).
  • Graft failure (rare).
  • Ankle joint stiffness in dorsoplantar direction.
  • Persistent ankle pain because of progressive osteoarthritis (OA) complaints.
  • Potential osseous impingement of the lateral gutter in the case that the graft has slight overhang or in case of the presence of a lateral osteophyte or multiple osteophytes on the lateral side of the ankle joint.

Funding

Open access funding provided by Amsterdam UMC (University of Amsterdam).

Declarations

Conflict of interest

J. Dahmen, Q.G.H. Rikken, G.M.M.J. Kerkhoffs, and S.A.S. Stufkens declare that they have no competing interests nor any conflicts of interest.
For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned in the article were in accordance with the ethical standards indicated in each case.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

Unsere Produktempfehlungen

e.Med Interdisziplinär

Kombi-Abonnement

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

e.Med Orthopädie & Unfallchirurgie

Kombi-Abonnement

Mit e.Med Orthopädie & Unfallchirurgie erhalten Sie Zugang zu CME-Fortbildungen der Fachgebiete, den Premium-Inhalten der dazugehörigen Fachzeitschriften, inklusive einer gedruckten Zeitschrift Ihrer Wahl.

Operative Orthopädie und Traumatologie

Print-Titel

Schritt-für-Schritt Darstellung von bewährten und neuen Operationsverfahren, detailliert illustrierte und einheitlich strukturierte Beiträge und CME-Punkte sammeln

Literatur
1.
Zurück zum Zitat Aae TF, Randsborg PH, Lurås H, Årøen A, Lian ØB (2018) Microfracture is more cost-effective than autologous chondrocyte implantation: a review of level 1 and level 2 studies with 5 year follow-up. Knee Surg Sports Traumatol Arthrosc 26:1044–1052PubMed Aae TF, Randsborg PH, Lurås H, Årøen A, Lian ØB (2018) Microfracture is more cost-effective than autologous chondrocyte implantation: a review of level 1 and level 2 studies with 5 year follow-up. Knee Surg Sports Traumatol Arthrosc 26:1044–1052PubMed
2.
Zurück zum Zitat Araoye I, Pinter Z, Lee S, Netto CC, Hudson P, Shah A (2019) Revisiting the prevalence of associated copathologies in chronic lateral ankle instability: are there any predictors of outcome? Foot Ankle Spec 12:311–315CrossRefPubMed Araoye I, Pinter Z, Lee S, Netto CC, Hudson P, Shah A (2019) Revisiting the prevalence of associated copathologies in chronic lateral ankle instability: are there any predictors of outcome? Foot Ankle Spec 12:311–315CrossRefPubMed
3.
Zurück zum Zitat Armiento AR, Stoddart MJ, Alini M, Eglin D (2018) Biomaterials for articular cartilage tissue engineering: learning from biology. Acta Biomater 65:1–20CrossRefPubMed Armiento AR, Stoddart MJ, Alini M, Eglin D (2018) Biomaterials for articular cartilage tissue engineering: learning from biology. Acta Biomater 65:1–20CrossRefPubMed
4.
Zurück zum Zitat Campbell TM, Reilly K, Laneuville O, Uhthoff H, Trudel G (2018) Bone replaces articular cartilage in the rat knee joint after prolonged immobilization. Bone 106:42–51CrossRefPubMed Campbell TM, Reilly K, Laneuville O, Uhthoff H, Trudel G (2018) Bone replaces articular cartilage in the rat knee joint after prolonged immobilization. Bone 106:42–51CrossRefPubMed
5.
Zurück zum Zitat Carter DR, Beaupre GS, Giori NJ, Helms JA (1998) Mechanobiology of skeletal regeneration. Clin Orthop Relat Res 355:S41–S55CrossRef Carter DR, Beaupre GS, Giori NJ, Helms JA (1998) Mechanobiology of skeletal regeneration. Clin Orthop Relat Res 355:S41–S55CrossRef
6.
Zurück zum Zitat Chen W, Tang K, Yuan C, Zhou Y, Tao X (2015) Intermediate results of large cystic medial osteochondral lesions of the talus treated with osteoperiosteal cylinder autografts from the medial tibia. Arthroscopy 31:1557–1564CrossRefPubMed Chen W, Tang K, Yuan C, Zhou Y, Tao X (2015) Intermediate results of large cystic medial osteochondral lesions of the talus treated with osteoperiosteal cylinder autografts from the medial tibia. Arthroscopy 31:1557–1564CrossRefPubMed
7.
Zurück zum Zitat Choi GW, Choi WJ, Youn HK, Park YJ, Lee JW (2013) Osteochondral lesions of the talus: are there any differences between osteochondral and chondral types? Am J Sports Med 41:504–510CrossRefPubMed Choi GW, Choi WJ, Youn HK, Park YJ, Lee JW (2013) Osteochondral lesions of the talus: are there any differences between osteochondral and chondral types? Am J Sports Med 41:504–510CrossRefPubMed
8.
Zurück zum Zitat Dahmen J, Kerkhoffs G, van Bergen CJA (2021) Editorial commentary: how far can the Arthroscope reach in the ankle joint? Arthroscopy 37:1258–1260CrossRefPubMed Dahmen J, Kerkhoffs G, van Bergen CJA (2021) Editorial commentary: how far can the Arthroscope reach in the ankle joint? Arthroscopy 37:1258–1260CrossRefPubMed
9.
Zurück zum Zitat Dahmen J, Lambers KT, Reilingh ML, van Bergen CJ, Stufkens SA, Kerkhoffs GM (2017) No superior treatment for primary osteochondral defects of the talus. Knee Surg Sports Traumatol Arthrosc 26:2142–2157CrossRefPubMedPubMedCentral Dahmen J, Lambers KT, Reilingh ML, van Bergen CJ, Stufkens SA, Kerkhoffs GM (2017) No superior treatment for primary osteochondral defects of the talus. Knee Surg Sports Traumatol Arthrosc 26:2142–2157CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Dimitriou R, Mataliotakis GI, Angoules AG, Kanakaris NK, Giannoudis PV (2011) Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review. Injury 42(Suppl 2):S3–S15CrossRefPubMed Dimitriou R, Mataliotakis GI, Angoules AG, Kanakaris NK, Giannoudis PV (2011) Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review. Injury 42(Suppl 2):S3–S15CrossRefPubMed
11.
Zurück zum Zitat Draper SD, Fallat LM (2000) Autogenous bone grafting for the treatment of talar dome lesions. J Foot Ankle Surg 39:15–23CrossRefPubMed Draper SD, Fallat LM (2000) Autogenous bone grafting for the treatment of talar dome lesions. J Foot Ankle Surg 39:15–23CrossRefPubMed
12.
Zurück zum Zitat Hu Y, Guo Q, Jiao C, Mei Y, Jiang D, Wang J et al (2013) Treatment of large cystic medial osteochondral lesions of the talus with autologous osteoperiosteal cylinder grafts. Arthroscopy 29:1372–1379CrossRefPubMed Hu Y, Guo Q, Jiao C, Mei Y, Jiang D, Wang J et al (2013) Treatment of large cystic medial osteochondral lesions of the talus with autologous osteoperiosteal cylinder grafts. Arthroscopy 29:1372–1379CrossRefPubMed
13.
Zurück zum Zitat Ito Y, Fitzsimmons JS, Sanyal A, Mello MA, Mukherjee N, O’Driscoll SW (2001) Localization of chondrocyte precursors in periosteum. Osteoarthritis Cartilage 9:215–223CrossRefPubMed Ito Y, Fitzsimmons JS, Sanyal A, Mello MA, Mukherjee N, O’Driscoll SW (2001) Localization of chondrocyte precursors in periosteum. Osteoarthritis Cartilage 9:215–223CrossRefPubMed
15.
Zurück zum Zitat Kerkhoffs G, Karlsson J (2019) Osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 27:2719–2720CrossRefPubMed Kerkhoffs G, Karlsson J (2019) Osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 27:2719–2720CrossRefPubMed
16.
Zurück zum Zitat Kerkhoffs GM, Reilingh ML, Gerards RM, de Leeuw PA (2016) Lift, drill, fill and fix (LDFF): a new arthroscopic treatment for talar osteochondral defects. Knee Surg Sports Traumatol Arthrosc 24:1265–1271CrossRefPubMed Kerkhoffs GM, Reilingh ML, Gerards RM, de Leeuw PA (2016) Lift, drill, fill and fix (LDFF): a new arthroscopic treatment for talar osteochondral defects. Knee Surg Sports Traumatol Arthrosc 24:1265–1271CrossRefPubMed
17.
Zurück zum Zitat Körner D, Ateschrang A, Schröter S, Aurich M, Becher C, Walther M et al (2020) Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 28:3339–3346CrossRefPubMed Körner D, Ateschrang A, Schröter S, Aurich M, Becher C, Walther M et al (2020) Concomitant ankle instability has a negative impact on the quality of life in patients with osteochondral lesions of the talus: data from the German Cartilage Registry (KnorpelRegister DGOU). Knee Surg Sports Traumatol Arthrosc 28:3339–3346CrossRefPubMed
20.
Zurück zum Zitat Lee M, Kwon JW, Choi WJ, Lee JW (2015) Comparison of outcomes for osteochondral lesions of the talus with and without chronic lateral ankle instability. Foot Ankle Int 36:1050–1057CrossRefPubMed Lee M, Kwon JW, Choi WJ, Lee JW (2015) Comparison of outcomes for osteochondral lesions of the talus with and without chronic lateral ankle instability. Foot Ankle Int 36:1050–1057CrossRefPubMed
21.
Zurück zum Zitat Maia FR, Carvalho MR, Oliveira JM, Reis RL (2018) Tissue engineering strategies for osteochondral repair. Adv Exp Med Biol 1059:353–371CrossRefPubMed Maia FR, Carvalho MR, Oliveira JM, Reis RL (2018) Tissue engineering strategies for osteochondral repair. Adv Exp Med Biol 1059:353–371CrossRefPubMed
23.
Zurück zum Zitat Matsushima S, Isogai N, Jacquet R, Lowder E, Tokui T, Landis WJ (2011) The nature and role of periosteum in bone and cartilage regeneration. Cells Tissues Organs 194:320–325CrossRefPubMedPubMedCentral Matsushima S, Isogai N, Jacquet R, Lowder E, Tokui T, Landis WJ (2011) The nature and role of periosteum in bone and cartilage regeneration. Cells Tissues Organs 194:320–325CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Nagerl H, Hansen C, Kubein-Meesenburg D, Fanghanel J, Dathe H, Dumont C et al (2016) The upper ankle joint: curvature morphology of the articulating surfaces and physiological function. Acta Bioeng Biomech 18:83–90PubMed Nagerl H, Hansen C, Kubein-Meesenburg D, Fanghanel J, Dathe H, Dumont C et al (2016) The upper ankle joint: curvature morphology of the articulating surfaces and physiological function. Acta Bioeng Biomech 18:83–90PubMed
26.
Zurück zum Zitat O’Driscoll SW (1999) Articular cartilage regeneration using periosteum. Clin Orthop Relat Res 367:S186–S203CrossRef O’Driscoll SW (1999) Articular cartilage regeneration using periosteum. Clin Orthop Relat Res 367:S186–S203CrossRef
27.
Zurück zum Zitat Park KH, Lee JW, Suh JW, Shin MH, Choi WJ (2016) Generalized ligamentous laxity is an independent predictor of poor outcomes after the modified Brostrom procedure for chronic lateral ankle instability. Am J Sports Med 44:2975–2983CrossRefPubMed Park KH, Lee JW, Suh JW, Shin MH, Choi WJ (2016) Generalized ligamentous laxity is an independent predictor of poor outcomes after the modified Brostrom procedure for chronic lateral ankle instability. Am J Sports Med 44:2975–2983CrossRefPubMed
28.
Zurück zum Zitat Pintus E, Baldassarri M, Perazzo L, Natali S, Ghinelli D, Buda R (2018) Stem cells in osteochondral tissue engineering. Adv Exp Med Biol 1058:359–372CrossRefPubMed Pintus E, Baldassarri M, Perazzo L, Natali S, Ghinelli D, Buda R (2018) Stem cells in osteochondral tissue engineering. Adv Exp Med Biol 1058:359–372CrossRefPubMed
29.
Zurück zum Zitat Reilingh ML, Kerkhoffs GM, Telkamp CJ, Struijs PA, van Dijk CN (2014) Treatment of osteochondral defects of the talus in children. Knee Surg Sports Traumatol Arthrosc 22:2243–2249CrossRefPubMed Reilingh ML, Kerkhoffs GM, Telkamp CJ, Struijs PA, van Dijk CN (2014) Treatment of osteochondral defects of the talus in children. Knee Surg Sports Traumatol Arthrosc 22:2243–2249CrossRefPubMed
30.
Zurück zum Zitat Reilingh ML, Lambers KTA, Dahmen J, Opdam KTM, Kerkhoffs G (2018) The subchondral bone healing after fixation of an osteochondral talar defect is superior in comparison with microfracture. Knee Surg Sports Traumatol Arthrosc 26:2177–2182CrossRefPubMed Reilingh ML, Lambers KTA, Dahmen J, Opdam KTM, Kerkhoffs G (2018) The subchondral bone healing after fixation of an osteochondral talar defect is superior in comparison with microfracture. Knee Surg Sports Traumatol Arthrosc 26:2177–2182CrossRefPubMed
32.
Zurück zum Zitat Roseti L, Parisi V, Petretta M, Cavallo C, Desando G, Bartolotti I et al (2017) Scaffolds for bone tissue engineering: state of the art and new perspectives. Mater Sci Eng C Mater Biol Appl 78:1246–1262CrossRefPubMed Roseti L, Parisi V, Petretta M, Cavallo C, Desando G, Bartolotti I et al (2017) Scaffolds for bone tissue engineering: state of the art and new perspectives. Mater Sci Eng C Mater Biol Appl 78:1246–1262CrossRefPubMed
33.
Zurück zum Zitat Saxena A, Eakin C (2007) Articular talar injuries in athletes: results of microfracture and autogenous bone graft. Am J Sports Med 35:1680–1687CrossRefPubMed Saxena A, Eakin C (2007) Articular talar injuries in athletes: results of microfracture and autogenous bone graft. Am J Sports Med 35:1680–1687CrossRefPubMed
35.
Zurück zum Zitat Shimozono Y, Yasui Y, Ross AW, Miyamoto W, Kennedy JG (2017) Scaffolds based therapy for osteochondral lesions of the talus: a systematic review. World J Orthop 8:798–808CrossRefPubMedPubMedCentral Shimozono Y, Yasui Y, Ross AW, Miyamoto W, Kennedy JG (2017) Scaffolds based therapy for osteochondral lesions of the talus: a systematic review. World J Orthop 8:798–808CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Spencer V, Illescas E, Maltes L, Kim H, Sathe V, Nukavarapu S (2018) Osteochondral tissue engineering: translational research and turning research into products. Adv Exp Med Biol 1058:373–390CrossRefPubMed Spencer V, Illescas E, Maltes L, Kim H, Sathe V, Nukavarapu S (2018) Osteochondral tissue engineering: translational research and turning research into products. Adv Exp Med Biol 1058:373–390CrossRefPubMed
38.
Zurück zum Zitat Thermann H, Becher C, Vannini F, Giannini S (2014) Autologous matrix-induced chondrogenesis and generational development of autologous chondrocyte implantation. Oper Tech Orthop 24:210–215CrossRef Thermann H, Becher C, Vannini F, Giannini S (2014) Autologous matrix-induced chondrogenesis and generational development of autologous chondrocyte implantation. Oper Tech Orthop 24:210–215CrossRef
39.
Zurück zum Zitat Valderrabano V, Leumann A, Rasch H, Egelhof T, Hintermann B, Pagenstert G (2009) Knee-to-ankle mosaicplasty for the treatment of osteochondral lesions of the ankle joint. Am J Sports Med 37(Suppl 1):105–111CrossRef Valderrabano V, Leumann A, Rasch H, Egelhof T, Hintermann B, Pagenstert G (2009) Knee-to-ankle mosaicplasty for the treatment of osteochondral lesions of the ankle joint. Am J Sports Med 37(Suppl 1):105–111CrossRef
41.
Zurück zum Zitat Wang DY, Jiao C, Ao YF, Yu JK, Guo QW, Xie X et al (2020) Risk factors for osteochondral lesions and osteophytes in chronic lateral ankle instability: a case series of 1169 patients. Orthop J Sports Med 8:2325967120922821PubMedPubMedCentral Wang DY, Jiao C, Ao YF, Yu JK, Guo QW, Xie X et al (2020) Risk factors for osteochondral lesions and osteophytes in chronic lateral ankle instability: a case series of 1169 patients. Orthop J Sports Med 8:2325967120922821PubMedPubMedCentral
42.
Zurück zum Zitat Weigelt L, Laux CJ, Urbanschitz L, Espinosa N, Klammer G, Götschi T et al (2020) Long-term prognosis after successful nonoperative treatment of osteochondral lesions of the talus: an observational 14-year follow-up study. Orthop J Sports Med 8:2325967120924183PubMedPubMedCentral Weigelt L, Laux CJ, Urbanschitz L, Espinosa N, Klammer G, Götschi T et al (2020) Long-term prognosis after successful nonoperative treatment of osteochondral lesions of the talus: an observational 14-year follow-up study. Orthop J Sports Med 8:2325967120924183PubMedPubMedCentral
43.
Zurück zum Zitat Xu C, Li M, Wang C, Liu H (2020) A comparison between arthroscopic and open surgery for treatment outcomes of chronic lateral ankle instability accompanied by osteochondral lesions of the talus. J Orthop Surg Res 15:113CrossRefPubMedPubMedCentral Xu C, Li M, Wang C, Liu H (2020) A comparison between arthroscopic and open surgery for treatment outcomes of chronic lateral ankle instability accompanied by osteochondral lesions of the talus. J Orthop Surg Res 15:113CrossRefPubMedPubMedCentral
Metadaten
Titel
Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for lateral osteochondral lesions of the talus: operative technique
verfasst von
Jari Dahmen, MD, BSc
Quinten G. H. Rikken, BSc
Gino M. M. J. Kerkhoffs, MD, PhD
Sjoerd A. S. Stufkens, MD, PhD
Publikationsdatum
09.01.2023
Verlag
Springer Medizin
Erschienen in
Operative Orthopädie und Traumatologie / Ausgabe 2/2023
Print ISSN: 0934-6694
Elektronische ISSN: 1439-0981
DOI
https://doi.org/10.1007/s00064-022-00789-0

Weitere Artikel der Ausgabe 2/2023

Operative Orthopädie und Traumatologie 2/2023 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.