Osteochondral lesions of the talus and the role of ankle arthroscopy
The options for treating OCL are numerous and a number of surgical procedures can be performed arthroscopically. Maire-Clare Killen and Rajiv Limaye shed light on a path of treatment that is constantly evolving
Osteochondral lesion (OCL) is a term used to describe an injury or abnormality of the articular cartilage and underlying bone [1]. Osteochondral lesions of the talus are an increasingly recognised and diagnosed pathology and can often be difficult to treat. They are thought to occur in up to 70 per cent of acute ankle fractures or ligament injuries, with trauma being by far the most common underlying aetiology [2]. In patients without history of injury, several other factors have been implicated in the development of such lesions. These include congenital predisposition, spontaneous osteonecrosis, ligamentous laxity, thromboembolic or endocrine disease and steroid treatment [3,4].
Forces acting across the tibio-talar joint are significantly higher in comparison with other joints; therefore, an articular injury can result in significant symptoms. The avascular nature of articular cartilage and the impaired healing potential can result in a lesion which progresses in size and severity if left untreated, with subsequent early ankle osteoarthritis [5,6]. …
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