The management of talar osteochondral lesions - Current concepts.

Autor: Lan T; Spinal Studies & Cartilage Research Group, Robert Jones and Agnes Hunt Orthopaedic Hospital, NHS Trust, Oswestry, UK.; School of Pharmacy and Bioengineering, Keele University, UK., McCarthy HS; Spinal Studies & Cartilage Research Group, Robert Jones and Agnes Hunt Orthopaedic Hospital, NHS Trust, Oswestry, UK.; School of Pharmacy and Bioengineering, Keele University, UK., Hulme CH; Spinal Studies & Cartilage Research Group, Robert Jones and Agnes Hunt Orthopaedic Hospital, NHS Trust, Oswestry, UK.; School of Pharmacy and Bioengineering, Keele University, UK., Wright KT; Spinal Studies & Cartilage Research Group, Robert Jones and Agnes Hunt Orthopaedic Hospital, NHS Trust, Oswestry, UK.; School of Pharmacy and Bioengineering, Keele University, UK., Makwana N; Robert Jones and Agnes Hunt Orthopaedic Hospital, NHS Trust, Oswestry, UK.; School of Pharmacy and Bioengineering, Keele University, UK.
Jazyk: angličtina
Zdroj: Journal of arthroscopy and joint surgery [J Arthrosc Jt Surg] 2021 Jul-Sep; Vol. 8 (3), pp. 231-237.
DOI: 10.1016/j.jajs.2021.04.002
Abstrakt: Osteochondral lesions of the talus (OLTs) are a common complication following trauma, involving both the articular cartilage and the underlying subchondral bone, with variable aetiologies and often presenting with non-specific symptoms. Diagnosis of OLTs requires a combination of clinical assessment and imaging and despite many different treatment options, there is no generalised consensus regarding which option is the most effective. Left untreated, OLTs risk progressing to osteoarthritis. Acute non-displaced OLTs can be treated non-operatively. However, OLTs refractory to non-surgical care for three to six months may be suitable for surgical care. In these cases, conservative treatments are often unsuccessful, particularly for larger and more severe defects and so the majority require surgical intervention. Although bone marrow stimulation techniques remain the "gold standard" for lesions <150 mm 2 , there still requires a need for better long term clinical data and cost-benefit analyses compared with other treatment options. Biological attempts at either regenerating or replacing the articular cartilage are however demonstrating some promising results, but each with their own advantages and disadvantages. In this review, we summarise the clinical management of OLTs and present the current concepts of different treatment regimes.
Competing Interests: None.
(Crown Copyright © 2021 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of International Society for Knowledge for Surgeons on Arthroscopy and Arthroplasty.)
Databáze: MEDLINE
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