Treatment of juvenile osteochondritis dissecans of the talus: current concepts review

Vannini, Francesca and Cavallo, Marco and Baldassarri, Matteo and Castagnini, Francesco and Olivieri, Alessandra and Ferranti, Enrico and Buda, Roberto and Giannini, Sandro (2014) Treatment of juvenile osteochondritis dissecans of the talus: current concepts review. Joints, 2 (4). pp. 188-191. ISSN 2282-4324

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Abstract

Juvenile osteochondritis dissecans of the talus (JODT) affects the subchondral bone primarily and, in a skeletally immature population, articular cartilage secondarily. It probably consists of aseptic bone necrosis whose spontaneous healing is impaired by microtraumas, resulting in an osteochondral injury and, in some cases, in osteoarthritis. In many cases the clinical presentation is asymptomatic. Mild chronic pain is frequent, sometimes accompanied by swelling, stiffness or locking. Few data are currently available on this topic and, moreover, most existing data were obtained from mixed groups and populations; it is therefore difficult to outline a scheme for the treatment of JODT. However, the most suitable treatment in the first stages of the disease is conservative. The presence of a loose body is an indication for surgical fixation, drilling or regenerative procedures, depending on the presence/extent of subchondral bone sclerosis and the surgeon’s experience. Drilling has been shown to promote the healing of lesions with minimal surgical trauma. Microfractures, since they induce fibrocartilage repair, are to be considered only for small injuries. Mosaicplasty and osteochondral autograft transplantation may cause donor site morbidity and are techniques little reported in JODT. Regenerative techniques and fresh allografts give good results in osteochondral lesions, but further studies are required to describe the results that can be obtained in JODT alone.

Item Type: Article
Uncontrolled Keywords: Ankle, juvenile, osteochondritis dissecans, microfractures, regenerative techniques
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia > 617.5 Medicina regionale; Chirurgia regionale
Depositing User: Chiara D'Arpa
Date Deposited: 14 Apr 2015 10:10
Last Modified: 14 Apr 2015 10:10
URI: http://eprints.bice.rm.cnr.it/id/eprint/10461

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