Int J Sports Med 2020; 41(12): 873-878
DOI: 10.1055/a-1186-1575
Clinical Sciences

Characteristics of Osteochondral Lesions of the Talus in Different Age Groups

Yongxing Cao
1   Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2   Department of Orthopedics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Yang Xu
1   Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2   Department of Orthopedics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Qiang Huang
1   Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2   Department of Orthopedics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Yuan Hong
1   Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2   Department of Orthopedics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Xiangyang Xu
1   Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2   Department of Orthopedics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
› Author Affiliations
Funding This study was supported by the National Natural Science Foundation of China (no. 81772372) and the Shanghai Municipal Health Commission (no. 201940339).

Abstract

We analyzed the characteristics of 112 consecutive patients who were operatively treated for osteochondral lesions of the talus from August 2014 to April 2019 in our hospital. The patients were divided into three age groups: young-adult (<40 years), middle-age (40–60 years) and old-age (>60 years). The basic clinical features, localization and size of the lesions, Hepple stage, and surgical procedures were compared among groups. Several significant differences were found on the characteristics of osteochondral lesions of the talus among age groups. There were more female patients in the old-age group (p<0.01), and old patients had a longer duration of symptoms (p<0.05). The OLTs in middle- and old-age patients were mostly located in the medial part of the talus with larger depth (p<0.01). Hepple stage 5, the cystic type, was very common in the old-age group (p<0.01). With regard to surgical procedures, more osteochondral autograft transplantations were applied in the old-age group (p<0.01). Female and deep medial talar subchondral cyst is the typical characteristics of patients over 60 years old. Age is an important factor that must be considered when choosing surgery procedure for patients with osteochondral lesions of the talus.



Publication History

Received: 22 March 2020

Accepted: 18 May 2020

Article published online:
20 July 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Kerkhoffs G, Karlsson J. Osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 2019; 27: 2719-2720
  • 2 Grossman JP, Lyons MC. A review of osteochondral lesions of the talus. Clin Podiatr Med Surg 2009; 26: 205-226
  • 3 Verhagen RA, Struijs PA, Bossuyt PM. et al. Systematic review of treatment strategies for osteochondral defects of the talar dome. Foot Ankle Clin 2003; 8: 233-242
  • 4 Flick AB, Gould N. Osteochondritis dissecans of the talus (transchondral fractures of the talus): Review of the literature and new surgical approach for medial dome lesions. Foot ankle 1985; 5: 165-185
  • 5 Rothrauff BB, Murawski CD, Angthong C. et al. Scaffold-based therapies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot Ankle Int 2018; 39: 41S-47S
  • 6 Shimozono Y, Yasui Y, Ross AW. et al. Scaffolds based therapy for osteochondral lesions of the talus: A systematic review. World J Orthop 2017; 8: 798-808
  • 7 Dombrowski ME, Yasui Y, Murawski CD. et al. Conservative management and biological treatment strategies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot Ankle Int 2018; 39: 9S-15S
  • 8 Hannon CP, Murawski CD, Fansa AM. et al. Microfracture for osteochondral lesions of the talus: A systematic review of reporting of outcome data. Am J Sports Med 2013; 41: 689-695
  • 9 El-Rashidy H, Villacis D, Omar I. et al. Fresh osteochondral allograft for the treatment of cartilage defects of the talus: A retrospective review. J Bone Joint Surg Am 2011; 93: 1634-1640
  • 10 Dekker TJ, Dekker PK, Tainter DM. et al. Treatment of osteochondral lesions of the talus: A critical analysis review. JBJS Rev 2017; 5: 01874474-201703000-00001
  • 11 Chuckpaiwong B, Berkson EM, Theodore GH. Microfracture for osteochondral lesions of the ankle: Outcome analysis and outcome predictors of 105 cases. Arthroscopy 2008; 24: 106-112
  • 12 Ferkel RD, Zanotti RM, Komenda GA. et al. Arthroscopic treatment of chronic osteochondral lesions of the talus: Long-term results. Am J Sports Med 2008; 36: 1750-1762
  • 13 Giannini S, Vannini F. Operative treatment of osteochondral lesions of the talar dome: current concepts review. Foot Ankle Int 2004; 25: 168-175
  • 14 Robinson DE, Winson IG, Harries WJ. et al. Arthroscopic treatment of osteochondral lesions of the talus. J Bone Joint Surg Br 2003; 85: 989-993
  • 15 Choi WJ, Kim BS, Lee JW. Osteochondral lesion of the talus: Could age be an indication for arthroscopic treatment?. Am J Sports Med 2012; 40: 419-424
  • 16 D’Ambrosi R, Maccario C, Serra N. et al. Relationship between symptomatic osteochondral lesions of the talus and quality of life, body mass index, age, size and anatomic location. Foot Ankle Surg 2018; 24: 365-372
  • 17 Choi GW, Choi WJ, Youn HK. et al. Osteochondral lesions of the talus: Are there any differences between osteochondral and chondral types?. Am J Sports Med 2013; 41: 504-510
  • 18 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
  • 19 Hepple S, Winson IG, Glew D. Osteochondral lesions of the talus: a revised classification. Foot Ankle Int 1999; 20: 789-793
  • 20 Elias I, Zoga AC, Morrison WB. et al. Osteochondral lesions of the talus: Localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int 2007; 28: 154-161
  • 21 Loomer R, Fisher C, Lloyd-Smith R. et al. Osteochondral lesions of the talus. Am J Sports Med 1993; 21: 13-19
  • 22 Li X, Zhu Y, Xu Y. et al. Osteochondral autograft transplantation with biplanar distal tibial osteotomy for patients with concomitant large osteochondral lesion of the talus and varus ankle malalignment. BMC Musculoskelet Disord 2017; 18: 23
  • 23 Irwin RM, Shimozono Y, Yasui Y. et al. Incidence of coexisting talar and tibial osteochondral lesions correlates with patient age and lesion location. Orthop J Sports Med 2018; 6: 2325967118790965
  • 24 Elias I, Jung JW, Raikin SM. et al. Osteochondral lesions of the talus: Change in MRI findings over time in talar lesions without operative intervention and implications for staging systems. Foot Ankle Int 2006; 27: 157-166
  • 25 Orr JD, Dutton JR, Fowler JT. Anatomic location and morphology of symptomatic, operatively treated osteochondral lesions of the talus. Foot Ankle Int 2012; 33: 1051-1057
  • 26 Tol JL, Struijs PA, Bossuyt PM. et al. Treatment strategies in osteochondral defects of the talar dome: A systematic review. Foot Ankle Int 2000; 21: 119-126
  • 27 Choi SW, Lee GW, Lee KB. Arthroscopic microfracture for osteochondral lesions of the talus: Functional outcomes at a mean of 6.7 years in 165 consecutive ankles. Am J Sports Med 2020; 48: 153-158
  • 28 Kreuz PC, Lahm A, Haag M. et al. Tibial wedge osteotomy for osteochondral transplantation in talar lesions. Int J Sports Med 2008; 29: 584-589
  • 29 Nguyen A, Ramasamy A, Walsh M. et al. Autologous osteochondral transplantation for large osteochondral lesions of the talus is a viable option in an athletic population. Am J Sports Med 2019; 47: 3429-3435
  • 30 Shimozono Y, Hurley ET, Myerson CL. et al. Good clinical and functional outcomes at mid-term following autologous osteochondral transplantation for osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 2018; 26: 3055-3062
  • 31 Shimozono Y, Donders JCE, Yasui Y. et al. Effect of the containment type on clinical outcomes in osteochondral lesions of the talus treated with autologous osteochondral transplantation. Am J Sports Med 2018; 46: 2096-2102
  • 32 Zhu Y, Xu X. Osteochondral autograft transfer combined with cancellous allografts for large cystic osteochondral defect of the talus. Foot Ankle Int 2016; 37: 1113-1118
  • 33 McGahan PJ, Pinney SJ. Current concept review: Osteochondral lesions of the talus. Foot Ankle Int 2010; 31: 90-101