C. Icing is important for the first 5-7 days post-op. Study design: Randomized controlled trial; Level of evidence, 1. Ice is applied for 20-minute periods 3-4 times per day. Your talus bone is the bottom part of the ankle joint. Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. Ankle Arthroscopy + Microfracture Talus OCD (Osteochondritis Dissecans lesion) Day of Surgery A. Messages 643 Best answers 0. C. coderguy1939 Guest. endobj
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Foot / Ankle :: Early Weight Bearing After OCD Talus Microfracture? The Event 2012. Jin Woo Lee. Talar dome lesions are usually caused by … Microfracture and stem cell injection work well for simple lesions. 3 0 obj
B. Arthroscopic debridement, microfracture and PRGF injections do not halt or delay the progression of OA ankle in type V OCD but helps in the healing of subchondral cyst. It is typically an effective treatment. Your Pensacola foot and ankle specialist can also use the MRI examination to date the defect and obtain information on the correlated bone bruise. Microfracture surgery, through the recent years, has become popular in sports with a number of professional athletes including NFL, NBA and NHL members, having undergone the surgery. Ankle Microfracture: Factors Affecting Clinical Outcome 07:58. Range of motion starts immediately unless you went through concurrent lateral ankle stabilization. (with MRI) Hi, By way of background, I was a long jumper/triple jumper on the track team in college and banged up my right ankle pretty badly a couple times, though nothing that resulted in long term pain. The real question is: are you doing what is best or what is simple? It is often associated with a traumatic injury such as a severe ankle sprain. After this, the calcified chondral layer is debrided to expose the underlying subchondral bone … Foot / Ankle :: Early Weight Bearing After OCD Talus Microfracture? <>
The cause of this condition is not fully known or understood. Pic after microfracture and debridement of above OCD. It connects your foot to the two bones in your lower leg — the tibia and fibula — that make up the top part of the ankle. If not recognized and treated correctly, osteochondritis dissecans can cause secondary osteoarthritis with functional limitation and pain. 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). Thanks . Patient will be released from the hospital the same day as surgery Normally, the osteochondral allograft transplant system and the microfracture have been regular options of … A full diagnostic arthroscopy is performed, and then attention is turned to the osteochondral defect. Jun 24, 2009 #2 I would go with unlisted 29999. The causes of microfracture OCD is still being debated, bit the development of repetitive micro-traumas correlated with vascular impairment is the most recognized analysis that causes progressive dysfunction and ankle pain in young and skeletally immature adult patients. Microfractures or Arthroscopic microdrilling are performed with the goal of obtaining bone marrow growth factors by breaking the subchondral calcified layer. <>/Metadata 191 0 R/ViewerPreferences 192 0 R>>
A series of intraop ankle arthroscopy pics of synovial chondromatosis with OCD talus and tibia and microfracture. Jun 29, 2009 #3 Take a look at 29891. osteochondritis dessicans (OCD) defect. 4 0 obj
Treatment Strategy and Surgical Approach for OCD of the Talus Feat. Without appropriate treatment, talus OCD have the potential to lead early cartilage degeneration and eventually osteoarthritis.1 Treatment options vary ranging from conservative treatment to arthroscopic debridement and microfracture (MFx), mosaicplasty, allograft applications or autologous chondrocyte transplantations. 24(4) 2016. I am 6 days out from microfracture surgery on my left talus to correct an OCD that is actually 25 years old. The code, CPT 28100 (excision or curettage of benign tumor or cyst of the talus or calcaneus), I believe, really fits the bill in describing what was done - excision, currettage, and drilling of the defect. This type of procedure is crucial particularly in patients who are young with unstable cartilage fragments. Rehabilitation Protocol: Ankle Arthroscopy WITH Talus OCD Microfracture Phase I - Post-operative Period (Weeks 0-1) • NON-weightbearing • Splint immobilization • Daily icing, compression and elevation home program Phase II (Weeks 1-3) • Weightbearing: Contine NON-weightbearing for 6 … incidence 69% of ankle fractures; 70% of ankle sprains; 10% are bilateral This is a relatively quick surgery performed by a Pensacola orthopedic surgeon (around 30 to 90 minutes) that is minimally invasive and has a much shorter recovery period than knee replacement (arthroplasty). endobj
A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. Am J Sports Med 2016;44;1292 -1300. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The patient will be NWB and use two crutches to protect the repair site and allow the site to heal properly. When a patient has a small area of damaged cartilage (not widespread arthritis), microfracture may be performed in an attempt to stimulate new cartilage growth. One can drill and inject these lesions. %PDF-1.7
These molecules should encourage filling of the cartilage defect with fibrocartilage that is less specialized. In addition, microfracture technique has proven to be effective for treatment of both chondral and osteochondral lesions of the talus . Microfracture OCD surgery requires you to be non-weightbearing in a cast that is removable. Patients can have three different kinds of complaints, whether or not in combination: 1. Osteochondritis Dissecans (OCD) is a joint defect involving the overlying articular cartilage and the subchondral bone. 2 0 obj
Depending on how big your lesion is will determine which procedure the surgeon will perform. “Osteo” means bone and “chondral” refers to cartilage. Overview. Hospital for Special Surgery. Microfracture is most often performed inside the knee joint, although it has also been used for treatment in other joints including the hip, ankle, and shoulder. The cause of this condition is not fully known or understood. �K�������8��xW��ԿC���oo�̛k��{)�t\O\��$���V�����8�c���p%]�+>}����������&qq ����MQU��.��EQ�$���a�2V����9 ����d����3����~GvO����|�P^���e '�8��hN �81��N�y'�M8�vߌ����3_Η/'����u5�;{�V��Yd��xv��5�K��Y�ڕ��l��^�Hi]�z Microfracture Osteochondral Lesions of Talar Dome Feat. 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; Epidemiology . This patient has a large OCD of the talar dome that causes consistent pain, stiffness and swelling in her ankle. Messages 499 Best answers 0. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
Depending on MRI findings, diagnosing OCD is fairly straightforward. Telephone: 850-435-4800 When performing a microfracture procedure, the surgeon will start by debriding any frayed tissue or flaps at the margin of the lesion (Figure 22). Pain medication as needed every 6 hours. Pic of an OCD in the talar dome due to pressure from the nodule. Ankle Arthroscopy with Microfracture Precautions: The patient will be splinted to restrict ROM. Microfracture or drilling: 4–6 weeks of nonweightbearing is recommended to allow the defect to heal, with ankle ROM encouraged. Microfracture is a surgical option used in the treatment of areas of damaged cartilage. Keywords osteochondral lesions of the talus, osteochondritis dessicans, microfracture, OLT, allograft, OATS, PJCAT, ACI, MACI, AMIC Osteochondral lesions of the talus (OLTs) are lesions of the articular cartilage of the talus and underlying subchondral bone. Fibrocartilage is predominantly made of Type I collagen which is structurally and biomechanically inferior to hyaline cartilage. Email address: info@nilssenorthopedics.com, Telephone: 850-435-4800 ���0 #�y���І�����|F��z ��1�
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�1�I�9���N(Yn%F��#�F�=�=�D���̦i�P�:�]J��J3O�3]_|�+�J�F��.�U|%zb�n_(*� m�0��ݺ���7A�����s#f�cF�!f�˨ٙ�a�_�������b=m�T����t�c�P�}̈�0p. dissecans (OCD) of talus ... sports after arthroscopic debridement and microfracture of osteochondral talar defects: a randomized, double -blind, placebo - controlled multicenter trial. Symptoms that correlate with small lesions are generally relieved with microfracture OCD surgery and the outcome is usually good. I am 6 days out from microfracture surgery on my left talus to correct an OCD that is actually 25 years old. To be honest, removal of an OCD lesion should probably be added to CPT 28100 code description. Back when I was 13 I was diagnosed and went the route of NWB for about 12 weeks rather than surgery. Diet as tolerated. Osteochondritis Dissecans (OCD) is a joint defect involving the overlying articular cartilage and the subchondral bone. Osteochondritis dissecans (OCD) of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. Indication for microfracture is recommended as a first-line treatment, especially in osteochondral defects of the talus measuring less than 1.5 cm 2 [57, 80]. Ankle arthroscopic surgery was initially performed to manage any intra-articular OCD, including debridement and microfracture. 2923 N California Ave Suite 300 Chicago, IL 60618 Phone: (847) 247-4000 720 Florsheim Drive Libertyville, IL 60048 Phone: (847) 247-4000 When it affects your ankle, it usually happens on the medial section of your ankle (talus) or the inner area. Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). 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