Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지
DOI QR코드

DOI QR Code

Supramalleolar Osteotomy Combined with Redo Arthroscopy for a Patient with Persistent Pain after Primary Arthroscopic Microfracture for Medial Osteochondral Lesion of the Talus: A Case Report

관절경 하 미세골절술 이후에도 통증이 지속되는 거골의 내측 골연골병변에 대하여 이차 관절경 수술과 함께 시행된 과상부절골술: 증례 보고

  • Tae Hun Song (Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Jin Soo Suh (Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Jun Young Choi (Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
  • 송태훈 (인제대학교 의과대학 일산백병원 정형외과학교실) ;
  • 서진수 (인제대학교 의과대학 일산백병원 정형외과학교실) ;
  • 최준영 (인제대학교 의과대학 일산백병원 정형외과학교실)
  • Received : 2023.01.20
  • Accepted : 2023.02.19
  • Published : 2023.06.15
Download PDF
⟨ Previous Next ⟩

Abstract

A medial opening wedge supramalleolar osteotomy (SMO) introduced by Takakura et al. is a useful realignment procedure for patients with ankle joint arthritis and varus malalignment by shifting the weight-bearing axis laterally and redistributing the loads on the ankle joint. When pain persists after arthroscopic microfracture in patients with medial osteochondral lesion of the talus (OLT), redo arthroscopy, osteochondral autograft transplantation, autologous chondrocyte implantation, or matrix-induced chondrogenesis might be indicated. On the other hand, there is insufficient scientific evidence for realignment surgery through SMO, while the effect of realignment surgery has been studied consecutively for osteochondral lesions of the knee. Therefore, this paper reports a patient with medial OLT who underwent redo arthroscopy combined with SMO for persistent pain after primary arthroscopic microfracture.

Keywords

References

  1. Choi WJ, Park KH, Lee M, Chung K, Lee JW. Redomicrofracture as a treatment for osteochondral lesion of talus after the failure of arthroscopic microfracture. J Korean Foot Ankle Soc. 2015;19:43-6. doi: 10.14193/jkfas.2015.19.2.43.
  2. Yoon HS, Park YJ, Lee M, Choi WJ, Lee JW. Osteochondral autologous transplantation is superior to repeat arthroscopy for the treatment of osteochondral lesions of the talus after failed primary arthroscopic treatment. Am J Sports Med. 2014;42:1896-903. doi: 10.1177/0363546514535186.
  3. Kim JS. Autologous chondrocyte implantation as a secondary procedure after failed microfracture for osteochondral lesion of talus. J Korean Foot Ankle Soc. 2015;19:7-10. doi: 10.14193/jkfas.2015.19.1.7.
  4. Kim BS, Na Y, Kwon WH. Operative treatment for osteochondral lesions of the talus: bone marrow aspirate concentrate and matrixinduced chondrogenesis. J Korean Foot Ankle Soc. 2020;24:61-8. doi: 10.14193/jkfas.2020.24.2.61.
  5. Mina C, Garrett WE Jr, Pietrobon R, Glisson R, Higgins L. High tibial osteotomy for unloading osteochondral defects in the medial compartment of the knee. Am J Sports Med. 2008;36:949-55. doi: 10.1177/0363546508315471.
  6. Agarwalla A, Christian DR, Liu JN, Garcia GH, Redondo ML, Gowd AK, et al. Return to work following high tibial osteotomy with concomitant osteochondral allograft transplantation. Arthroscopy. 2020;36:808-15. doi: 10.1016/j.arthro.2019.08.046.
  7. Savva N, Jabur M, Davies M, Saxby T. Osteochondral lesions of the talus: results of repeat arthroscopic debridement. Foot Ankle Int. 2007;28:669-73. doi: 10.3113/FAI.2007.0669.
  8. Arshad Z, Aslam A, Iqbal AM, Bhatia M. Should arthroscopic bone marrow stimulation be used in the management of secondary osteochondral lesions of the talus? A systematic review. Clin Orthop Relat Res. 2022;480:1112-25. doi: 10.1097/CORR.0000000000002134.
  9. Li X, Zhu Y, Xu Y, Wang B, Liu J, Xu X. 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. doi: 10.1186/s12891-016-1367-2.
  10. Kim YM, Kim KI, Han B.If the lower extremity alignment is corrected, will osteochondral lesions of the talus improve? J Korean Foot Ankle Soc. 2020;24:42-7. doi: 10.14193/jkfas.2020.24.2.42.