From the Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey.
J Am Acad Orthop Surg. 2021 Mar 15;29(6):e258-e266. doi: 10.5435/JAAOS-D-20-00636.
Osteochondral lesions in the talus are frequently seen disorders that can cause chronic ankle pain. Surgical treatment is determined by the size and location of the lesion. The microfracture procedure and additional application of scaffold technique have gained popularity for the treatment of small osteochondral defects. However, these techniques may be insufficient and have poor outcomes in deep lesions. Therefore, several different invasive surgical techniques that require the malleolar osteotomy have been described. Problems associated with the invasive surgical intervention may be seen such as reduction loss in the osteotomy site, delayed union or nonunion, permanent pain, and/or swelling. We describe a new all-arthroscopic technique for the treatment of deep talus osteochondral lesions using an autologous bone graft taken from the tibial plafond region together with a chitosan-based noncellular scaffold.
距骨骨软骨损伤是常见的疾病,可导致慢性踝关节疼痛。手术治疗取决于病变的大小和位置。微骨折术和额外应用支架技术已广泛用于治疗小的骨软骨缺损。然而,这些技术在深部病变中可能不够有效,且效果不佳。因此,已经描述了几种需要踝骨切开术的不同侵袭性手术技术。与侵袭性手术干预相关的问题可能包括:骨切开部位的复位丢失、延迟愈合或不愈合、永久性疼痛和/或肿胀。我们描述了一种新的全关节镜技术,使用取自胫骨平台区域的自体骨移植物和基于壳聚糖的非细胞支架治疗深部距骨骨软骨病变。