Hulme, CH ORCID: https://orcid.org/0000-0002-4961-2185, Lan, T, McCarthy, HS ORCID: https://orcid.org/0000-0001-9534-7565, Makwana, N and Wright, KT ORCID: https://orcid.org/0000-0001-8842-5908 (2021) The Management of Talar Osteochondral Lesions - Current Concepts. The Journal of Arthoscopy and Joint Surgery.

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Abstract

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 mm2, 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.

Item Type: Article
Additional Information: The final version of this accepted manuscript will be available from the publishers at https://www.journals.elsevier.com/journal-of-arthroscopy-and-joint-surgery/#:~:text=Journal%20of%20Arthroscopy%20and%20Joint%20Surgery%20%28JAJS%29%20is,the%20Journal%20is%20to%20present%20wide-ranging%2C%20multi-disciplinary%20perspectives. Please refer to any relevant terms and conditions. Crown Copyright©2021 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of International Society for Knowledge for Surgeons on Arthroscopy andArthroplasty. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Uncontrolled Keywords: Ankle; talus; osteochondral lesion; osteochondral defect; treatment
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Depositing User: Symplectic
Date Deposited: 23 Apr 2021 08:42
Last Modified: 18 May 2021 12:59
URI: https://eprints.keele.ac.uk/id/eprint/9355

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