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Amol Saxena, DPM FACFAS
Long Term Results of Injuries to the Talar Dome
Palo Alto , CA
To show the results of surgical treatment of injuries to the talar dome and determine their efficacy. As new technologies and treatments emerge, these results need to be documented.
Surgical treatment of traumatically induced osteochondral defects have better results than osteochondritis dissecans. Medial malleolar osteotomy may predispose patients to medial tibio-talar degeneration. Standard arthroscopic techniques may not allow for adequate visualization and treatment of these lesions. Open arthrotomy currently yields better access and results.
Patients with osteochondral lesions and osteochondritis dissecans have few treatment options available to them when "routine" excision, drilling and curettement fail. New technologies available for other joints may be able to be modified for talar lesions.
Nineteen patients with the diagnoses of osteochondral defect (OCD) and osteochondritis dissecans (OD) of the talar dome were reviewed. Fifteen patients underwent open surgical treatment. One patient with bilateral OD necessitated "reoperation" on one side, two years after initial treatment. Two patients with medial OCD with previous arthroscopic treatment elsewhere had continued symptoms; one underwent subsequent open repair with relief of symptoms. Athletic patients fared better than non-athletic patients. Two posterolateral lesions were identified, and healed with conservative treatment.
