The most common sites are the posteromedial (53%) ( Fig. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The result is a persistent deep pain in the ankle and recurrent swelling with activity. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Osteochondral lesions of the talar dome are relatively common causes of ankle pain and disability. Appropriate management is therefore vital. There is an association with trauma to the ankle, particularly in lateral talar dome lesions. 69% of ankle fractures. The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. When an injury occurs to the cartilage and underlying bone of the talus within the ankle joint it is called a talar dome lesion. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Symptoms of Osteochondral Lesion of the Talus. Immobilization – Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. Approximately 50% of ankle sprains and up to 73% of ankle fractures result in some level of cartilage injury, and there are over 2 million ankle sprains alone per year. The talar dome is trapezoidal in shape, and its anterior surface is, on average, 2.5 mm wider than the posterior surface. On the basis of repetitive microtraumas, avascular … The medial lesions tend to be deeper and cup shaped whereas the lateral lesions tend to be thinner and more wafer shaped . The vast majority of lateral lesions are associated with a distinct traumatic episode and patients … During this period of immobilization, nonweightbearing range-of-motion exercises may be recommended. Hereby, the most common reasons are a severe inversion ankle sprain, chronic ankle instability (CAI; causing in 5–9% of the cases a lateral talar OCL), 9, 10 or a fracture mechanism. Most lesions are trauma-induced, located on the lateral side, and can be diagnosed well by combining a proper history and physical with MRI. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). An osteo-chondral lesion is a defect in the upper surface of the talus that involves bone (osteo) and cartilage (chondral). Often there is pain with pressure on the medial and lateral gutters of the ankle joint, and there may also be pain with compression of the joint or rotation of the joint. “Osteo” means bone and “chondral” refers to cartilage. Talar dome lesions usually occur from an injury, such as an ankle sprain. Epidemiology. Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. The medial and lateral articular facets of the talus articulate with the medial and lateral malleoli. Cause. An osteochondral lesion of the talar dome is a condition characterized by damage to the cartilage and / or bone surfaces of the upper (superior) aspect of the talus bone (i.e. non-surgical treatment fails to relieve the symptoms of talar dome Treatment depends on the severity of the talar dome lesion. Osteochondral lesions of the talus, or talar dome lesions, can be classified as ischaemic or traumatic injuries and can be debilitating if untreated. The ankle OCD lesion is rare in the pediatric population, mainly occurring in adults with the average age being 21 years of age. OCD lesions of the elbow are typically found in athletes in the teen years after the physis has closed. Talar dome fractures are often missed at the initial examination following an ankle sprain or injury. It is often associated with a traumatic injury, such as a severe ankle sprain. Trauma is the most common cause, but ischemic necrosis, endocrine disorders, and genetic factors may have etiologic significance. Talar dome lesions … There are differing degrees of severity varying from very small undisplaced lesions to those that create large loose bodies and develop cysts in the talus. Treatment for osteochondral lesions of the talar dome vary depending on the severity of the injury. However, medial lesions are more common than lateral OCLs. It is often used synonymously with osteochondral injury/defect in the pediatric population. “Osteo” means bone and “chondral” refers to cartilage. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following non-surgical treatment options may be considered: 1. “Osteo” means bone and “chondral” refers to cartilage. If left untreated, osteochondral lesions of the talar dome can develop into arthritis. (1,2,3) Talar dome injuries create a focal defect in the dome of the talus that results in injury to the cartilage and underlying bone. Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. Talar dome lesions … Lateral lesions are located in the middle third of the talar dome and are shallow and wafer- shaped. “Osteo” means bone and “chondral” refers to cartilage. One of the best diagnostic tests of an ankle osteochondral lesion of the talus is a diagnostic anesthetic injection of the ankle joint. Talar dome lesions … This presents as a more challenging condition to treat and can often only be addressed by surgical intervention. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Most often present with a chief complaint of a sprained ankle. Methods: A professional rugby league player underwent surgery for a complex injury to the ankle. 1 ) and anterolateral (46%) talar dome ( 1 ). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Figure 1 Relevant Anatomy for an Osteochondral Lesion of the Talar Dome Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): The treatment given for the sprain or injury usually fails to treat the unidentified fracture. In these cases, the most affected area is the posteromedial talar dome (see Table 71-1). Other terms used include an osteochondral defect (OCD), osteochondral lesion of the talus (OLT) and osteochondritis dessecans, which are all used interchangeably. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. It is currently accepted that OCL of the talus is primarily traumatic in origin. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. Osteochondral lesions of the talus are an increasingly recognised pathology of the ankle joint and can lead to significant complications if not treated appropriately. Also known as a talar dome lesion, this condition causes pain and swelling within the ankle, and left untreated, may lead to long-term damage to the bone. The dome of the talus is covered by the trochlear articular surface, which supports the weight of the body. the talar dome) in the ankle. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Osteochondraldefect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. 66 The mechanism for traumatic impaction of the lateral … Berndt and Harty proved this in a report in which anteromedial and posterolateral lesions were created using cadavers.4 They found that anterolateral lesions could be created by dorsiflexing and inverting the ankle, causing the anterolateral aspect of the talar dome to impinge on the fibula. OCD usually causes pain during and after sports. Talar dome injuries result from trauma to the ankle including ankle sprains (6-38% of all ankle sprains), fractures (greater than 70% of all ankle fractures). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Symptoms of osteochondral lesions of the talus tend to develop gradually, and … Medial lesions are typically located in the posterior third of the talar dome and are deeper and cup shaped (2). It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). incidence. ankle to move smoothly.A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint.It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT).“Osteo”means bone and “chondral”refers to cartilage. Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. 44,61,70 Classic teaching is that lateral OLTs are more likely due to trauma than medial lesions, with 94% of lateral lesions and 62% of medial lesions being caused by trauma. 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